Summary: A new study links daily diet to mortality risk. People over 40 who eat one meal a day have a higher risk of death. Those who skip breakfast have an increased risk of death from cardiovascular disease, and those who eat meals less than 4.5 hours apart have an increased risk of death.
Eating just one meal a day is associated with an increased risk of death in American adults ages 40 and older, according to a new study in the Journal of the Academy of Nutrition and Dietetics.
Skipping breakfast is associated with a higher risk of cardiovascular disease mortality and missing lunch or dinner with all-cause mortality.
Even among people who eat three meals a day, eating two adjacent meals less than or 4.5 hours apart is associated with a higher risk of death from all causes.
“At a time when intermittent fasting is widely touted as a solution for weight loss, metabolic health, and disease prevention, our study is important for the large segment of American adults who eat fewer than three meals a day. Our research found that people who ate only one meal a day were more likely to die than those who ate more meals a day.
Among them, participants who skip breakfast are more likely to develop life-threatening cardiovascular diseases, while those who skip lunch or dinner increase their risk of death from any cause,” noted lead author Yangbo Sun. , MBBS, Ph.D., Department of Preventive Medicine. , University of Tennessee Health Sciences Center, Memphis. TN, United States. “Based on these results, we recommend eating at least two to three meals spread throughout the day.”
Investigators analyzed data from a cohort of more than 24,000 American adults aged 40 and older who participated in the National Health and Nutrition Survey (NHANES) between 1999 and 2014. A continuing health survey and nationally representative of the noninstitutionalized U.S. population, NHANES collects a wide range of health-related data to assess diet, nutritional status, general health, disease history, and health behaviors all both years.
The mortality status and cause of the 4,175 deaths identified among this group were determined from the NHANES public use linked mortality file. Investigators observed a number of common characteristics among participants eating less than three meals a day (about 40% of respondents): they were more likely to be younger, male, non-Hispanic black, being less educated and having a lower family income, smoking, drinking more alcohol, being food insecure and eating less nutritious foods, more snacks and less energy intake in general.
“Our results are significant even after adjustments for dietary and lifestyle factors (smoking, alcohol consumption, physical activity levels, energy intake and diet quality) and food insecurity,” said the study’s principal investigator, Wei Bao, MD, Ph.D., Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. He noted: “Our conclusions are based on observations drawn from publicly available data and do not imply causation. Nevertheless, what we observed has a metabolic meaning.
Dr. Bao explained that skipping meals generally means ingesting a greater energy load at the same time, which can compound the burden of regulating glucose metabolism and lead to further metabolic deterioration. This may also explain the association between a shorter meal interval and mortality, since a shorter time between meals would lead to a greater energy load during the given period.
Dr Bao commented, “Our research provides much-needed evidence on the association between eating behaviors and mortality in the context of meal times and the length of the daily prandial period.”
Meal frequency, skipping, and intervals were not addressed by the Dietary Guidelines for Americans 2020-2025 because the Dietary Guidelines Advisory Committee “was unable to find sufficient evidence to summarize the evidence between feeding frequency and health”.
Previous dietary studies and dietary guidelines for Americans have primarily focused on food components and food combinations.
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Original research: Free access.
“Meal skipping and shorter meal intervals are associated with increased risk of all-cause mortality and cardiovascular disease in American adults” by Yangbo Sun et al. Journal of the Academy of Nutrition and Dietetics
Skipping meals and shorter meal intervals are associated with an increased risk of all-cause mortality and cardiovascular disease in American adults
Previous dietary studies and current dietary guidelines have primarily focused on food intake and eating habits. Little is known about the association between eating behaviors such as meal frequency, skips and intervals, and mortality.
The aim was to examine the associations between meal frequency, skipping and intervals with all-cause mortality and cardiovascular disease (CVD).
This was a prospective study.
A total of 24,011 adults (aged ≥40 years) who participated in the National Health and Nutrition Survey 1999-2014 were included in this study. Eating behaviors were assessed using a 24-hour recall. Death and underlying causes of death were determined by linking to death records up to December 31, 2015.
Outcomes were all-cause and CVD mortality.
Statistical analyzes carried out
Multivariate Cox proportional hazards models were used to estimate adjusted hazard ratios (RRs) of all-cause and CVD mortality.
During the 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most participants ate three meals a day. Compared with participants taking three meals a day, the multivariate adjusted RRs for participants taking one meal a day were 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 multivariate adjusted RRs of 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariate adjusted RRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1, 32) to skip dinner compared to those who did not. Among participants eating three meals a day, the multivariate adjusted RR for participants with a mean interval of ≤ 4.5 hours between two adjacent meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, compared to those with a meal interval of 4.6 to 5.5 hours.
In this large, prospective study of American adults aged 40 or older, eating one meal a day was associated with an increased risk of all-cause and CVD mortality. Skipping breakfast was associated with an increased risk of CVD mortality, while skipping lunch or dinner was associated with an increased risk of all-cause mortality. Among participants eating three meals a day, a meal interval of ≤ 4.5 hours in two adjacent meals was associated with higher all-cause mortality.
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