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Abstract
Observational studies have demonstrated an inverse relationship between eating frequency (EF), obesity, and other markers for disease risk. It has been suggested that consumption of several small, frequent meals may influence physiological mechanisms, reducing the risk for disease and lowering appetite. Participants in this randomized crossover study completed two intervention phases lasting three weeks each: one of low eating frequency ("low-EF"; 3 eating occasions/day) and one of high eating frequency ("high-EF"; 8 eating occasions/day). Fasting C-reactive protein, insulin-like growth factor, and leptin were measured at baseline and endpoint of each phase and an optional subjective appetite testing session lasting four hours was offered at the endpoint of each phase. During appetite testing sessions, participants consumed an amount of food equal in total energy and macronutrient content at either one occasion at 8:00 am ("low-EF" condition) or spread evenly over two smaller eating occasions at 8:00 am and 10:30 am ("high-EF" condition). Ratings of hunger, desire to eat, fullness, thirst, and nausea were made every 30 minutes using paper-and-pencil semi-anchored 100-mm Visual Analog Scales. A composite appetite score was calculated as the mean of hunger, desire to eat, and 100-fullness. The generalized estimating equation modification of linear regression was used to compare fasting plasma biomarkers and mean ratings of subjective appetite. A total of 15 participants completed both study phases (4 males, 11 females). Mean (± SD) age was 28.5 ± 8.70, and mean (± SD) BMI was 23.3 ± 3.4. There was a non-significant, but suggestive trend toward higher plasma hsCRP in the high-EF condition compared to the low-EF condition (p=0.09). Mean IGF-I was lower in the high-EF condition as compared to the low-EF condition (p<0.001). Regression models showed no association between EF and plasma leptin concentrations (p=0.83). Twelve participants completed appetite testing (4 males, 8 females). Mean composite appetite was higher in the high-EF condition for the total testing period baseline through 12:00 pm (p<0.05) and for the time period baseline through 10:30 am (p<0.001). No significant difference was detected between conditions in mean composite appetite for the final hour of testing (p=0.12). Findings suggest that when the energy and macronutrient content of the diet is equal, the consumption of smaller, more frequent meals may not positively impact inflammatory profiles or aid in appetite control. Further studies are needed to confirm the inflammatory impact of more frequent food consumption and to determine the physiological mechanisms driving the relationship between eating frequency and health.
