Abstract
Background
Epidemiologic evidence is sparse on the effect of dietary behaviors and diet quality
on body mass index (BMI; calculated as kg/m2), which can be important drivers of the obesity epidemic.
Objective
This study investigated the relationships of frequency of eating and time of intake
to energy density, nutrient quality, and BMI using data from the International Study
on Macro/Micronutrients and Blood Pressure including 2,696 men and women aged 40 to
59 years from the United States and the United Kingdom.
Design
The International Study on Macro/Micronutrients and Blood Pressure is a cross-sectional
investigation with four 24-hour dietary recalls and BMI measurements conducted between
1996 and 1999. Consumption of solid foods was aggregated into eating occasion. Nutrient
density is expressed using the Nutrient Rich Food Index 9.3. The ratio of evening/morning
energy intake was calculated; mean values of four visits were used.
Statistical analyses performed
Characteristics across eating occasion categories are presented as adjusted mean with
corresponding 95% CI. Multiple linear regression models were used to examine associations
of eating occasions, ratio of evening/morning energy intake, dietary energy density,
and Nutrient Rich Food Index 9.3 with BMI.
Results
Compared to participants with fewer than four eating occasions in 24 hours, those with
six or more eating occasions in 24 hours had lower mean BMI (27.3 vs 29.0), total energy
intake (2,129 vs 2,472 kcal/24 hours), dietary energy density (1.5 vs 2.1 kcal/g),
and higher Nutrient Rich Food Index 9.3 (34.3 vs 28.1). In multiple regression analyses,
higher evening intake relative to morning intake was directly associated with BMI;
however, this did not influence the relationship between eating frequency and BMI.
Conclusions
Our results suggest that a larger number of small meals may be associated with improved
diet quality and lower BMI. This may have implications for behavioral approaches to
controlling the obesity epidemic.
Keywords
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Biography
G. S. Aljuraiban is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.
Biography
Q. Chan is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.
Biography
L. M. Oude Griep is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.
Biography
I. J. Brown is a research associates, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.
Biography
P. Elliott is a professor, Medical Research Council (MRC) and Public Health England (PHE) Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK.
Biography
G. S. Frost is a professor, The Nutrition and Dietetic Research Group, Imperial College London, UK.
Biography
M. L. Daviglus is an adjunct professor, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Biography
J. Stamler is professor emeritus, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Biography
L. Van Horn is a professor, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Article info
Publication history
Published online: January 22, 2015
Accepted:
November 19,
2014
Footnotes
Supplementary materials: Tables 3 and 6 are available at www.andjrnl.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT The International Collaborative Study of Macronutrients, Micronutrients, and Blood Pressure (INTERMAP) is supported by grants R01 HL50490 and R01 HL084228 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. Work with the UK samples was funded by a project grant from the West Midlands National Health Service Research and Development and grant no. R2019EPH from the Chest, Heart, and Stroke Association, Northern Ireland. The sponsors had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript. Ghadeer S. Aljuraiban is supported by King Saud University, Riyadh, Saudi Arabia. Gary S. Frost and Paul Elliott are supported in part by the National Institute for Health Research (NIHR) Biomedical Research Centre, Imperial College Healthcare NHS Trust and Imperial College London. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, or the Department of Health. This observational study is registered at www.clinicaltrials.gov as NCT00005271.
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© 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
