Summary: A new study links daily eating to mortality risk. Those over the age of 40 who eat one meal a day have a higher risk of mortality. Those who skip breakfast are at increased risk of death associated with cardiovascular disease, and those who eat meals less than 4.5 hours apart are at increased risk of mortality.
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Eating just one meal a day is associated with an increased risk of mortality in American adults age 40 and older, according to a new study in the Journal of the Academy of Nutrition and Dietetics.
Skipping breakfast is associated with increased risk of cardiovascular disease mortality and skipping lunch or dinner with all-cause mortality.
Even among people who eat three meals a day, eating two meals in a row less than 4.5 hours apart is associated with a higher risk of death from all causes.
“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 large segment of American adults who eat fewer than three meals a day. Our research revealed that people who eat just one meal a day are more likely to die than those who eat more meals a day.
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. Tennessee, United States. “Based on these findings, we recommend eating at least two to three meals spread out throughout the day.”
The researchers analyzed data from a cohort of more than 24,000 US 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 non-institutionalized US population, NHANES collects a wide range of health-related data to assess diet, nutritional status, general health, disease history, and health behaviors every two years.
Mortality status and cause of the 4175 identified deaths in this group were determined from the NHANES public use-related mortality file. Researchers observed a number of common characteristics among participants who ate fewer than three meals a day (about 40% of those surveyed): they were more likely to be younger, male, non-Hispanic black, less educated, and higher family income low, smoke, drink more alcohol, be food insecure and eat less nutritious food, more snacks and less overall energy intake.
“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 the principal investigator of the study Wei Bao, MD, Ph.D., Department of Epidemiology, School of Public Health, University of Iowa, Iowa City, IA, USA. He noted, “Our findings are based on observations drawn from public data and do not imply causation. . However, what we observe makes metabolic sense.”
Dr. Bao explained that skipping meals generally means taking in a larger energy load at one time, which can add to the burden of glucose metabolism regulation and lead to further metabolic decline. This may also explain the association between a shorter meal interval and mortality, since a shorter time between meals would result in a higher energy load in the given period.
Dr Bao commented, “Our research provides much-needed evidence on the association between eating behaviors and mortality in the context of meal timing and daily prandial length.”
Meal frequency, omissions, and timing 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 meal frequency and health.”
Previous dietary studies and the Dietary Guidelines for Americans have focused primarily on dietary components and food combinations.
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original research: Open access.
“Skipping meals and shorter meal intervals are associated with increased risk of all-cause mortality and cardiovascular disease among US adults.” by Yangbo Sun et al. Journal of the Academy of Nutrition and Dietetics
Summary
Skipping meals and shorter meal intervals are associated with increased risk of all-cause mortality and cardiovascular disease among US adults.
See also
Background
Previous dietary studies and current dietary guidelines have focused primarily on dietary intake and eating patterns. Little is known about the association between eating behaviours, such as meal frequency, skipping and intervals, and mortality.
Goal
The objective was to examine the associations of meal frequency, omission, and timing with all-cause and cardiovascular disease (CVD) mortality.
Design
This was a prospective study.
Participants/scenario
A total of 24,011 adults (age ≥ 40 years) who participated in the National Health and Nutrition Examination Survey 1999-2014 were included in this study. Eating behaviors were assessed by 24-h recall. Death and underlying causes of death were determined by linking to death records up to December 31, 2015.
The main measures
Outcomes were all-cause and CVD mortality.
Statistical analyzes performed
Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) for all causes and CVD mortality.
Results
During the 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most of the participants ate three meals a day. Compared with participants eating three meals per day, the multivariate adjusted HRs for participants eating 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 CVD mortality. . Participants who skipped breakfast have a multivariate adjusted HR of 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariate 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 ) to skip dinner compared to those who did not. Among participants consuming three meals per day, the multivariate adjusted HR for participants with a mean interval of ≤4.5 hours at two consecutive meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, compared with those with a meal interval of 4.6 to 5.5 hours.
conclusions
In this large prospective study of US adults age 40 and older, eating one meal a day was associated with increased risk of all-cause mortality and CVD. Skipping breakfast was associated with a higher risk of CVD mortality, while skipping lunch or dinner was associated with a higher risk of all-cause mortality. Among participants with three meals a day, a meal interval of ≤4.5 hours at two adjacent meals was associated with higher all-cause mortality.
