Summary: A new study links daily eating with risk of death. Those over 40 who ate one meal a day had a higher risk of dying. Those who skip breakfast have an increased risk of cardiovascular disease-related death, and those who eat meals less than 4.5 hours apart have an increased risk of mortality.
A new study showed in Journal of the Academy of Nutrition and Dietetics.
Skipping breakfast is associated with an increased risk of cardiovascular disease and missing lunch or dinner with all-cause mortality.
Even among individuals who ate three meals a day, eating two adjacent meals less than or equal to 4.5 hours apart was associated with a higher risk of all-cause mortality.
“While intermittent fasting is widely promoted as a solution to weight loss, metabolic health, and disease prevention, our study is significant for a large segment of American adults who eat less than three meals per day. Our research revealed that individuals who eat only one meal per day They are more likely to die than those who eat more daily meals.
Among these, participants who skip breakfast have a higher risk of fatal cardiovascular disease, while those who skip lunch or dinner have an increased risk of death from all causes,” noted lead author Yangbo Sun, MBBS, PhD. Ph.D., Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis. Tennessee, U.S. “Based on these findings, we recommend eating at least two to three meals spread out throughout the day.”
Investigators analyzed data from a cohort of more than 24,000 American adults age 40 and older who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. A nationally representative ongoing health survey of the non-institutionalized American population, NHANES collects a wide range of From health-related data to assess diet, nutritional status, general health, disease history, and health behaviors every two years.
The status and cause of deaths of the 4175 deaths identified among this cohort were ascertained from the associated NHANES public use mortality profile. The investigators noted a number of common characteristics among participants who ate less than three meals per day (about 40% of the respondents) – they are more likely to be younger, male, non-Hispanic black, have less education and family income, smoke, drink more alcohol , food insecurity, eating more nutritious foods, more snacks, and overall lower energy intake.
“Our findings are significant even after adjustments for dietary and lifestyle factors (smoking, alcohol use, physical activity levels, energy intake, and diet quality) and food insecurity,” said study senior investigator Wei Bao, MD, PhD. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States. He noted, “Our findings are based on observations from public data and do not indicate causation. However, what we observed has metabolic meaning.”
Dr. Bao explained that skipping meals usually means eating more energy at one time, which can exacerbate the burden of regulating glucose metabolism and lead to subsequent metabolic deterioration. This could also explain the association between a shorter meal period and mortality, as a shorter time between meals would result in a greater energy load in the given period.
Dr. Bao commented, “Our research contributes to much-needed evidence on the relationship between eating behaviors and mortality in the context of meal timing and the duration of the daily eating period.”
Meal frequency, skipping, and eating intervals were not addressed in the 2020-2025 Dietary Guidelines for Americans because the Dietary Guidelines Advisory Committee “could not find sufficient evidence to summarize the evidence between eating frequency and health.”
Previous dietary studies and the Dietary Guidelines for Americans have focused primarily on food ingredients and food formulations.
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“Skipping meals and shorter meal times are associated with an 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
Skipping meals and shorter meal times are associated with an increased risk of all-cause mortality and cardiovascular disease among US adults.
Previous dietary studies and current dietary guidelines have focused primarily on dietary intake and eating patterns. Little is known about the relationship between eating behaviors such as meal frequency and skipping, time periods, and mortality.
The aim was to examine the associations of meal frequency, skipping, and interval intake with all-cause cardiovascular disease (CVD) mortality.
This was a prospective study.
A total of 24,011 adults (aged 40 years) who participated in the 1999-2014 National Health and Nutrition Examination Survey were included in this study. Eating behaviors were assessed using a 24-hour recall. Death and underlying causes of death were confirmed by linking to death records up to 31 December 2015.
main outcome measures
The results were all-cause CVD mortality.
Performed statistical analyzes
Multivariate Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality.
During the 185,398 person-year follow-up period, 4,175 deaths occurred, including 878 deaths from cardiovascular disease. Most of the participants ate three meals a day. Compared with participants who ate three meals per day, the multivariate adjusted heart rates for participants who ate one meal per day was 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 (95% CI 1.26 to 2.65) for cardiovascular mortality. Participants who skipped breakfast had a multivariate-adjusted heart rate of 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariate adjusted HR for all-cause mortality was 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared with those who did not. Among the participants who ate three meals per day, the multivariate adjusted heart rate for participants with a mean meal interval of 4.5 hours at two adjacent 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.
In this large, prospective study of US adults aged 40 years or older, eating one serving per day was associated with an increased risk of all-cause and cardiovascular death. Skipping breakfast was associated with an increased risk of cardiovascular disease, while skipping lunch or dinner was associated with an increased risk of all-cause mortality. Among participants who ate three meals a day, a meal duration of 4.5 hours at two adjacent meals was associated with higher all-cause mortality.