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Concept: Meals

50

Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions. Furthermore, we propose definitions for meals, snacks, and eating occasions for use in research. Finally, data suggest that irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile. Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management.

Concepts: Epidemiology, Nutrition, Snack food, Meal, Breakfast, Dinner, Meals, Lunch

46

Background: Scientific evidence for the optimal number, timing, and size of meals is lacking.Objective: We investigated the relation between meal frequency and timing and changes in body mass index (BMI) in the Adventist Health Study 2 (AHS-2), a relatively healthy North American cohort.Methods: The analysis used data from 50,660 adult members aged ≥30 y of Seventh-day Adventist churches in the United States and Canada (mean ± SD follow-up: 7.42 ± 1.23 y). The number of meals per day, length of overnight fast, consumption of breakfast, and timing of the largest meal were exposure variables. The primary outcome was change in BMI per year. Linear regression analyses (stratified on baseline BMI) were adjusted for important demographic and lifestyle factors.Results: Subjects who ate 1 or 2 meals/d had a reduction in BMI per year (in kg · m(-2) · y(-1)) (-0.035; 95% CI: -0.065, -0.004 and -0.029; 95% CI: -0.041, -0.017, respectively) compared with those who ate 3 meals/d. On the other hand, eating >3 meals/d (snacking) was associated with a relative increase in BMI (P < 0.001). Correspondingly, the BMI of subjects who had a long overnight fast (≥18 h) decreased compared with those who had a medium overnight fast (12-17 h) (P < 0.001). Breakfast eaters (-0.029; 95% CI: -0.047, -0.012; P < 0.001) experienced a decreased BMI compared with breakfast skippers. Relative to subjects who ate their largest meal at dinner, those who consumed breakfast as the largest meal experienced a significant decrease in BMI (-0.038; 95% CI: -0.048, -0.028), and those who consumed a big lunch experienced a smaller but still significant decrease in BMI than did those who ate their largest meal at dinner. Conclusions: Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain. Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.

Concepts: Regression analysis, Linear regression, Body mass index, Meal, Dinner, Meals, Lunch, Seventh-day Adventist Church

36

Adults, regardless of whether they are parents, regularly eat meals with family at home, but few studies have analyzed large, population-based samples to examine how mealtime practices or family meal frequency are associated with health.

Concepts: Nutrition, Food, Snack food, Meal, Meals

32

Do people believe that sharing food might involve sharing more than just food? To investigate this, participants were asked to rate how jealous they (Study 1)–or their best friend (Study 2)–would be if their current romantic partner were contacted by an ex-romantic partner and subsequently engaged in an array of food- and drink-based activities. We consistently find–across both men and women–that meals elicit more jealousy than face-to-face interactions that do not involve eating, such as having coffee. These findings suggest that people generally presume that sharing a meal enhances cooperation. In the context of romantic pairs, we find that participants are attuned to relationship risks that extra-pair commensality can present. For romantic partners left out of a meal, we find a common view that lunch, for example, is not “just lunch.”

Concepts: Food, Interpersonal relationship, Restaurant, Meal, Dinner, Meals, Lunch, Jealousy

30

The aim of this study is to investigate if reported childhood food habits predict the food habits of students at present. Questions addressed are: does the memory of childhood family meals promote commensality among students? Does the memory of (grand)parents' cooking influence students' cooking? And, is there still a gender difference in passing on everyday cooking skills? Using a cross-sectional survey, 104 students were asked about their current eating and cooking habits, and their eating habits and the cooking behaviour of their (grand)parents during their childhood. Results show that frequencies in reported childhood family meals predict frequencies of students' commensality at present. The effects appear for breakfast and dinner, and stay within the same meal: recalled childhood family breakfasts predict current breakfast commensality, recalled childhood family dinners predict current dinner commensality. In terms of recalled cookery of (grand)parents and the use of family recipes a matrilineal dominance can be observed. Mothers are most influential, and maternal grandmothers outscore paternal grandmothers. Yet, fathers' childhood cooking did not pass unnoticed either. They seem to influence male students' cookery. Overall, in a life-stage of transgression students appear to maintain recalled childhood food rituals. Suggestions are discussed to further validate these results.

Concepts: Food, Mother, Meal, Cooking, Breakfast, Dinner, Meals, Full breakfast

24

Although previous research has associated the glycaemic load (GL) of a meal with cognitive functioning, typically the macro-nutrient composition of the meals has differed, raising a question as to whether the response was to GL or to the energy, nutrients or particular foods consumed. Therefore, the present study contrasted two breakfasts that offered identical levels of energy and macro-nutrients, although they differed in GL.

Concepts: Nutrition, Food, Carbohydrate, Meal, Breakfast, Dinner, Meals, Full breakfast

19

Controlling hunger between meals is a challenge for many individuals. This manuscript comprises 2 sequential clinical trials investigating the effects of psyllium (Metamucil) on satiety, both using a randomized, double-blind, placebo-controlled cross-over design. The first study determined the effects of 3.4 g, 6.8 g, and 10.2 g of psyllium taken before breakfast and lunch for 3 days. The second study determined the effects of 6.8 g (taken before breakfast and lunch on Days 1 and 2 and before breakfast on Day 3) on the satiety of participants receiving an energy restricted meal in the morning (breakfast) for 3 days. Efficacy endpoints were mean inter-meal hunger, desire to eat, and Satiety Labeled Intensity Magnitude Visual Analog Scale scores. In Study 1, all 3 psyllium doses resulted in directional or statistically significant mean reduction in hunger and desire to eat, and increased fullness between meals compared to placebo, with both higher doses better than placebo or 3.4 g. The 6.8 g dose provided more consistent (p ≤ 0.013) satiety benefits versus placebo. In Study 2, satiety was assessed similarly to Study 1. A significant (p ≤ 0.004) decrease in the 3-day mean hunger and desire to eat, as well as an increase in fullness for psyllium relative to placebo was observed. Most adverse events were mild gastrointestinal symptoms and were similar for psyllium compared to placebo. These results indicate that psyllium supplementation contributes to greater fullness and less hunger between meals.

Concepts: Clinical trial, Statistics, Effectiveness, Clinical research, Placebo, Meal, Dinner, Meals

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BACKGROUND: To assess the association of eating meals, and never watching TV while eating meals, with weight status among children, ages 10–12 years across Europe. METHODS: 7915 children (mean age: 11.5 years) in eight European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Slovenia, Spain and Switzerland) completed a questionnaire at school. Data on meals eaten the day before questionnaire administration and the frequency of eating meals while watching TV were collected. Height and weight of the children were objectively assessed. Multinomial and binary regression analyses were conducted to test associations of eating meals (adjusted for gender and ethnicity) and never watching TV while eating meals (adjusted for gender, ethnicity and total TV time) with overweight/obesity, and to test for country- and socio-demographic differences. RESULTS: The proportions of children reporting eating breakfast, lunch and dinner were 85%, 96%, and 93% respectively, and 55%, 46% and 32% reported to never watch TV at breakfast, lunch and dinner respectively. The children who ate breakfast (OR = 0.6 (95% CI 0.5-0.7)) and dinner (OR = 0.4 (95% CI 0.3-0.5)), had lower odds of being overweight compared to those who did not. The children who never watched TV at lunch (OR = 0.7 (95% CI 0.7-0.8)) and dinner (OR = 0.8 (95% CI 0.7-0.9)) had lower odds of being overweight compared to those who watched TV at the respective meals. CONCLUSIONS: The odds of being overweight was lower for children who ate breakfast and dinner compared to those who did not eat the respective meals. The odds of being overweight was lower for children who reported to never watch TV at lunch and dinner compared to those who did. A focus towards meal frequency and watching TV during meals in longitudinal and interventions studies in prevention of overweight and obesity, may contribute to a better understanding of causality.

Concepts: Europe, Meal, Dinner, Meals

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The objective was to examine the effect of consuming breakfast on subsequent energy intake. Participants who habitually ate breakfast and those who skipped breakfast were recruited for two studies. Using a randomized crossover design , the first study, examined the effect of having participants consume either (a) no breakfast, (b) a high carbohydrate breakfast (335 kcals) or © a high fiber breakfast (360) kcals on three occasions and measured ad libitum intake at lunch. The second study again used a randomized crossover design but with a larger, normal carbyhydrate, breakfast consumed ad libtum. Intake averaged 624 kcals and subsequent food intake was measured throughout the day.Participants ate only foods served from the Cornell Human Metabolic Research Unit where all foods were weighed before and after consumption. In the first study, neither eating breakfast nor the kind of breakfast consumed had an effect on the amount consumed at lunch despite a reduction in hunger ratings. In the second study, intake at lunch as well as hunger ratings was significantly increased after skipping breakfast, by 144 Kcal, leaving a net caloric deficit of 408 Kcal by the end of the day.These data are consistent with published literature demonstrating that skipping a meal does not result in accurate energy compensation at subsequent meals and suggests that skipping breakfast may be an effective means to reduce daily energy intake in some adults.

Concepts: Clinical trial, Metabolism, Nutrition, Food, Restaurant, Meal, Calorie, Meals

10

Background/Objectives:Timing of food intake associates with body weight regulation, insulin sensitivity and glucose tolerance. However, the mechanism is unknown. The aim of this study was to investigate the effects of changes in meal timing on energy-expenditure, glucose-tolerance and circadian-related variables.Subjects/Methods:32 women [aged 24±4 y and BMI 22.9±2.6 kg/m(2)] completed two randomized, crossover protocols: one protocol (P1) including resting-energy-expenditure (indirect-calorimetry) and glucose-tolerance (mixed-meal-test) (n=10), the other (P2) including circadian-related measurements based on profiles in salivary cortisol and wrist temperature (Twrist) (n=22). In each protocol, participants were provided with standardized meals (breakfast, lunch and dinner) during the two meal intervention weeks and were studied under two lunch eating conditions: Early Eating (EE; lunch at 13:00) and Late Eating (LE; lunch 16:30).Results:LE, as compared to EE, decreased pre-meal resting-energy-expenditure (P=0.048), a lower pre-meal protein-corrected-respiratory-quotient (CRQ), and a changed post-meal profile of CRQ (P=0.019). These changes reflected a significantly lower pre-meal utilization of carbohydrates in LE versus EE (P= 0.006). LE also increased glucose Area-Under-Curve above fasting by 46%, demonstrating decreased glucose tolerance (P=0.002). Changes in the daily profile of cortisol and Twrist were also found with LE blunting the cortisol profile, with lower morning and afternoon values, and suppressing the postprandial Twrist peak (P<0.05).Conclusions:Eating late is associated with decreased resting-energy-expenditure, decreased fasting carbohydrate oxidation, decreased glucose-tolerance, blunted daily profile in free cortisol concentrations, and decreased thermal effect of food on Twrist. These results may be implicated in the differential effects of meal timing on metabolic health.International Journal of Obesity accepted article preview online, 14 October 2014. doi:10.1038/ijo.2014.182.

Concepts: Nutrition, Enzyme, Insulin, Food, Carbohydrate, Meal, Dinner, Meals