How many times a day do you eat? How many times a should you eat? Is there even a correct answer to this conundrum? The short answer is that it does not matter much.

 The preponderance of the research suggests that increased meal frequency does not play a significant role in decreasing body weight/weight composition [1].

There has to be a better way, right?

There has to be a better way, right?

This requires accounting for an impact on under-reporting, meal skipping and other confounding variables during observational studies. Many of these observational studies were done using self-reporting dietary intake. Over-eating and under-reporting is common, especially when individuals are overweight or obese, which most were in these studies [2-8].

The majority of experimental studies examining meal frequency and weight loss recruit overweight or obese individuals.

When total daily calories were held constant (but hypocaloric) it was reported that the amount of body weight lost was not different even as meal frequency increased from a range of one meal per day up to nine meals per day [9-13].

Most recently in 2010, Cameron et al. [14] examined the effects of an eight week hypocaloric diet in both obese male and female participants. The subjects consumed either three meals per day (low meal frequency) or three meals plus three additional snacks (high meal frequency). Individuals in both the high and low meal frequency groups had the same caloric restriction (~700 kcals/day). 

Both groups lost ~5% of their initial weight as well as similar decreases in lean mass, fat mass and overall BMI [14]. 

There have been a few studies that include 'normal' weight individuals when looking at meal frequency. In relation to improvements in body weight and body composition, the results were similar to those of the overweight/obese trials - no improvements with increasing meal frequencies [15-18].

Oddly, when improvements in body composition were noted as a result of increasing meal frequency, the population studied was an athletic population.

What about blood sugar, satiety and keeping my/your metabolism going all day? Well, the research is a bit mixed on these topics. The rabbit hole can get pretty deep at this juncture, so I will keep this short and to-the-point.

Protein. This where the nutrition piece should start and will help to manage the above paradox. One study suggested that the protein content of total caloric intake is more important than the frequency of the meals in terms of preserving lean tissue [11].

Based on recent research, it appears that skeletal muscle protein synthesis on a per meal basis may be optimized at approximately 20 to 30 grams of high-quality protein, or 10-15 grams of essential amino acids [19-21].

A typical American diet distributes their protein intake unequally, such that the least amount of protein is consumed with breakfast (~10-14 grams), while the majority of protein is consumed with dinner (~29-42 grams) [22]. Thus, in the American diet, protein synthesis would likely only be optimized once per day with dinner.

One way we can look at establishing the meal frequency is to establish the total protein intake for the day (based on your lean mass) and divide this into appropriately balanced meals. From there we fill in the blanks regarding carbs and fat and figure out how this all fits into your schedule.

The reality is, meal frequency is largely based on personal preference with sociological and cultural factors mixed in with some potential genetic influence. Do not let anyone tell you that you have to do it their way. Let's figure out what works for you.

Until next time,

Dr. Tom  

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    References.

    1. La Bounty et al. Journal of the International Society of Sports Nutrition 2011, 8:4
    http://www.jissn.com/content/8/1/4.

    2. . Crawley H, Summerbell C: Feeding frequency and BMI among teenagers aged 16-17 years. Int J Obes Relat Metab Disord 1997, 21(2):159-61.

    3. Bandini LG, Schoeller DA, Cyr HN, Dietz WH: Validity of reported energy intake in obese and nonobese adolescents. Am J Clin Nutr 1990,52(3):421-5.

    4. Black AE, Prentice AM, Goldberg GR, Jebb SA, Bingham SA, Livingstone MB, Coward WA: Measurements of total energy expenditure provide insights into the validity of dietary measurements of energy intake. J Am Diet Assoc 1993, 93(5):572-9.

    5. Braam LA, Ocke MC, Bueno-be-Mesquita HB, Seidell JC: Determinants of obesity-related underreporting of energy intake. Am J Epidemiol 1998, 147(11):1081-6.

    6. Heitmann BL, Lissner L: Dietary underreporting by obese individuals–is it specific or non-specific? Bmj 1995, 311(7011):986-9.

    7. Prentice AM, Black AE, Coward WA, davies HL, Goldberg GR, Murgatroyd PR, Ashford J, Sawyer M, Whitehead RG: High levels of energy expenditure in obese women. Br Med J (Clin Res Ed) 1986, 292(6526):983-7.

    8. Schoeller DA, Bandini LG, Dietz WH: Inaccuracies in self-reported intake identified by comparison with the doubly labelled water method. Can J Physiol Pharmacol 1990, 68(7):941-9.

    9. Bortz WM, Wroldsen A, Issekutz B Jr, Rodahl K: Weight loss and frequency of feeding. N Engl J Med 1966, 274(7):376-9

    10. Finkelstein B, Fryer BA: Meal frequency and weight reduction of young women. Am J Clin Nutr 1971, 24(4):465-8.

    11.  Garrow JS, Durrant M, Blaza S, Wilkins D, Royston P, Sunkin S: The effect of meal frequency and protein concentration on the composition of the weight lost by obese subjects. Br J Nutr 1981, 45(1):5-15.

    12. Verboeket-van de Venne WP, Westerterp KR: Frequency of feeding, weight reduction and energy metabolism. Int J Obes Relat Metab Disord 1993,17(1):31-6.

    13. Young CM, Scanlan SS, Topping CM, Simko V, Lutwak L: Frequency of feeding, weight reduction, and body composition. J Am Diet Assoc 1971,59(5):466-72.

    14. Cameron JD, Cyr MJ, Doucet E: Increased meal frequency does not promote greater weight loss in subjects who were prescribed an 8-week equi-energetic energy-restricted diet. Br J Nutr 2010, 103(8):1098-101.

    15. Farshchi HR, Taylor MA, Macdonald IA: Decreased thermic effect of food after an irregular compared with a regular meal pattern in healthy lean women. Int J Obes Relat Metab Disord 2004, 28(5):653-60.

    16.  Stote KS, Baer DJ, Spears K, Paul DR, Harris GK, Rumpler WV, Strycula P, Najjar SS, Ferrucci L, Ingram DK, Longo DL, Mattson MP: A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. Am J Clin Nutr 2007, 85(4):981-8.

    17.  Swindells YE, Holmes SA, Robinson MF: The metabolic response of young women to changes in the frequency of meals. Br J Nutr 1968, 22(4):667-80.

    18. Wolfram G, Kirchgessner M, Müller HL, Hollomey S: Thermogenesis in humans after varying meal time frequency. Ann Nutr Metab 1987, 31(2):88-97

    19. Dangin M, Guillet C, Garcia-Rodenas C, Gachon P, Bouteloup-Demange C, Reiffers-Magnani K, Fauquant J, Beaufrere B: The rate of protein digestion affects protein gain differently during aging in humans. J Physiol 2003, 549(Pt 2):635-44.

    20. Moore DR, Robinson MJ, Fry JL, Tang JE, Glover EI, Wilkinson SB, Prior T, Tarnopolsky MA, Phillips SM: Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men. Am J Clin Nutr 2009, 89(1):161-8.

    21. Bohe J, Low A, Wolfe RR, Rennie MJ: Human muscle protein synthesis is modulated by extracellular, not intramuscular amino acid availability: a dose-response study. J Physiol 2003, 552(Pt 1):315-24.

    22. What We Eat in America, NHANES 2007-2008. 2008 [http://www.ars.usda.  gov/SP2UserFiles/Place/12355000/pdf/0708/tables_1-36_2007-2008.pdf].

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