Saturday, May 24, 2014

Does the Optimal Meal Frequency Depend on Age? Study Suggests: Kids Better Eat Often, Adolescents Rather Step Away From Their Sugary Sins - Quality Counts!

Frequent Meals Are a Good Thing For Young Kids But Not For Older Ones Who Will Self-Select Their Snacks
My recently published article "Many Small Meals Suck! Especially For Diabetics. Human Study Shows 6 Small Meals Mess W/ Blood Sugar Control, Make You Hungry and Decrease The Metabolic Rate" (read more) has caused quite a stir in the comment section on the article page, as well as on Facebook.

Obviously, we are not all the same, and I did never imply that one or another of the the extra-ordinary SuppVersity readers will thrive on a six+ meal a day regimen. What most people who freaked out totally forgot, though, is that said article was not about a study in which the subjects eat as much as they wanted. It was a study with restricted energy intake.

What I really wanted to highlight is thus, that with any diet that delivers less nutrients than you would need in given time period, even a non-significantly higher decrease in basal energy expenditure in response to an increase in meal frequencies is significant! It's significant with respect to the longstanding claim that "eating frequently will keep your metablism running, when you're dieting"... a claim the study by Kahleova et al. would clearly refute.

But enough of these dict chestnuts. Let's take at the latest contribution researchers from the , University of Ulster have recently made to the never-ending debate about the  "optimal" meal frequency (Murakami. 2014; Note: If there is one thing, I can tell you for sure, it's that there is no one-size fits it all optimum!)In contrast to the previously cited study, the study Kentaro Murakami and M. Barbara E. Livingstone published in the 111th issue of the British Journal of Nutrition is based on epidemiological data from British children aged 4 –10 years (n=818) and adolescents aged 11– 18 years (n=818).
You can learn more about meal frequency at the SuppVersity

Grazin' Bad For the Obese!

Breakfast Keeps You Lean?!

Frequent Protein Consumption

Myth: Few Meals More Bodyfat

8 Meals = Stable, But High Insulin

Int. Fasting & Exercise
The scientists assesssed the dietary intake was assessed using a 7 d weighed dietary record. The exact meal / eating frequency (EF) was calculated based on all eating occasions, except for those providing, 210 kJ (57.3kcal) of energy. Based on the available data on metabolic risk factors (i.e. total, HDL-cholesterol and LDL-cholesterol concentrations, TAG concentration, BMI z-score, waist:height ratio, and systolic and diastolic blood pressures), Murakami & Livingstone eventually calculated the age, sex, social class, physical activity, levels, protein, fat, total sugar and dietary fibre intake, as well as ratio of reported energy intake to estimated energy requirement (EI:EER) adjusted adiposity, high blood pressure and cardiovascular disease (CVD) risks for the kids and adolescents.
"Subjects with a higher EF were more likely to be boys (only adolescents), be in nonmanual social class and be physically active (only children). Additionally, EF was positively associated with EI:EER, EI and energy-adjusted intakes of carbohydrate and total sugar and inversely associated with energy-adjusted intakes of protein, fat (only adolescents), starch and dietary fibre." (Murakami. 2014)
What? Well, ok, let's make it easier: The well-off kids ate more frequently and were more active. Boys who were more active ate more frequently.
Figure 1: Difference in macronutrient and total sugar intake between kids and adolescents who eat 3-4 meals per day and those who consume 6 meals or more, i.e. the first and third tertile of eating frequencies (Murakami. 2014)
And, a a closer analysis of the data and the differences in macronutrient composition between the first (3-4 meals per day) and the third (6+ meals per day) tertile in Figure 1 clearly indicate, the frequent eaters consumed...
  • significantly more energy (relative to their needs),
  • significantly more carbs, and total sugar, as well as
  • less protein, starch and dietary fibre
I guess by now you are not surprise to hear that the number of "meals" per day was independently and positively associated with BMIz-score in the adolescent study participants. What may come as a surprise, is the reduced blood pressure in the young(er) frequent eaters - the children (age 4-10), of which the smartest among you will by now already have gathered that it's not the result of frequent eating, but a confounding factor which is like the frequent meals contingent with the increased physical activity ... Yes, right: The athletic kids! I am referring to this ever-shrinking minority of 4-10 years who are actually engaging in physical activity.
Figure 2: Physical activity according to age and meal frequency (Murakami. 2014)
So is inactivity the thing to blame? Probably not! It's not as if the adolescents were less active - on the contrary, the number of very active adolescents is even 11.4% higher than that of the 4-10 year-olds (see Figure 2). It's rather their "advantage" of being old enough to go and buy their own snacks which appears to haunt them. I mean, we all know that many parents have no clue what they are doing, but the obesity-triggering increase in total sugar and total energy intake in adolescents is unlikely that this is exclusively their parents' fault.

Practically speaking have thus arrived at one of the ever-recurring principle of sensible nutrition, here at the SuppVersity: In an unrestricted diet scenario, food quality is the major determinant of health and disease, leanness and obesity.
  • Kahleova, et al. "Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study." Diabetologia (2014). Ahead of print.
  • Murakami, Kentaro, and M. Barbara E. Livingstone. "Associations of eating frequency with adiposity measures, blood lipid profiles and blood pressure in British children and adolescents." British Journal of Nutrition 111.12 (2014): 2176-2183.