Meal timing and frequency in CVD prevention: an AHA scientific statement
Irregular eating patterns are less ideal for maintaining body weight and cardiometabolic health.
Irregular eating patterns are less ideal for maintaining body weight and optimal cardiometabolic health, according to a scientific statement released by the American Heart Association (AHA) and published in Circulation. The AHA found that intentional eating with attention to timing and frequency could lead to a healthier lifestyle and cardiometabolic risk factor management.
The AHA reviewed the effects of certain eating patterns on cardiometabolic health, including skipping breakfast, intermittent fasting, meal frequency, and timing of eating occasions.
Epidemiologic and clinical intervention data show that daily breakfast consumption among adults may decrease the risk of adverse effects related to glucose and insulin metabolism, and dietary counseling that supports breakfast consumption could be helpful to promote healthy eating habits throughout the day.
Epidemiologic studies provide strong evidence of a relation between skipping breakfast and risk of overweight obesity, metabolic risk profile, diabetes, CVD, and hypertension. However, clinical intervention findings found increasing evidence that advice related to breakfast consumption does not improve weight loss, most likely because of other behaviors during the day.
The AHA also identified evidence that suggests alternate-day fasting and periodic fasting may be effective for weight loss, but there are no data that determine whether the weight loss can be sustained. Alternate-day fasting and periodic fasting could also be useful to lower triglyceride concentrations but have little effect on cholesterol concentrations. These eating patterns may also help to lower blood pressure with a minimum weight loss of 6%.
The agency identified 9 trials that examined the impact of meal frequency without calorie restriction on cardiovascular risk, but it found that altering meal frequency according to isocaloric conditions may not be useful for lowering body weight or improving cardiometabolic risk factors.
In addition, the AHA found that meals consumed later in the evening could have potentially detrimental effects on cardiometabolic health, but additional research should be conducted to confirm the extent of this effect.
“Although more direct translational research is still needed, these data suggest that intervening on meal timing and frequency may be beneficial,” the study authors noted. “By focusing on meal frequency and timing as an intervention target, patients may directly address poor dietary quality without the need to deal with calorie restriction to promote weight loss.
“Ultimately, the clinician's goal may be to help the patient spread energy intake over a defined portion of the day in a more balanced way rather than limited to 1 segment of the day or continuously over long periods of time.”
- St-Onge MP, Ard J, Baskin ML, et al. Meal timing and frequency: Implications for cardiovascular disease prevention: A scientific statement from the American Heart Association. Circulation. 2017. doi:10.1161/cir.00000000000000476