Timing is Everything: Study Spotlight Take-Away with Chef Dr. Mike

by Michael S. Fenster, MD

“We must use time as a tool, not as a couch.”
— John F. Kennedy

Increasingly, evidence is accumulating that the health effects of the meals we eat extend beyond simply the nutrients consumed, although there continues to be a fervent dedication to “nutritionism” that borders on fanaticism. It dominates the discussion of food and health and, unfortunately, the recommendations that are ultimately prescribed to the lay public. Auspiciously, researchers continue to probe other undiscovered countries of inquiry and return to us nuggets of wisdom and insight. Evidence continues to build that such variables as how and when we eat (the emerging science of chrononutrition, which has been touched upon in earlier columns) can significantly impact our well-being, irrespective of what we consume. Recent studies have suggested that increased meal frequency (at least six meals per day) increases the risk of chronic disease and that, conversely, consuming fewer meals (one to three meals per day) and consuming them earlier in the day may improve markers of metabolic health such as inflammatory markers.

This week’s study of more than 2,000 people from Brazil sought to probe those connections.

The Study:

  • The study consisted of 2,050 participants aged 18 to 65 from across Brazil.
  • The study excluded shift workers.
  • The average age was 34 years old, and the study group was 73 percent women, and the rate of obesity (as defined by BMI–body mass index) was 15 percent.
  • The study used standard BMI measures to define obesity.
  • BMI was correlated with:
    • the timing of the largest meal of the day (breakfast, lunch, or dinner)
    • the number of meals per day (three or less versus three or more).

The Take-Away:

  • Those reporting dinner as the largest meal of the day were 67 percent more likely to have a higher BMI.
  • Those who ate more than three meals per day were 32 percent less likely to be obese.
  • Those who reported lunch as the largest meal of the day were also less likely to be obese.
  • These associations were statistically significant and independent of sex, age, marital status, education level, diet quality, sleep duration, and weekly frequency of physical exercise.

The Caveat:
These findings are consistent with others within the emerging field of chrononutrition. However, a closer look at this data introduces a critical concept: there are important health-related effects surrounding mealtime that are distinctly separate from the quantity and quality of the food we eat. In viewing the food-health equation over the last half-century, the focus has been primarily – if not exclusively – on the quantity and quality of meal contents, with little regard for anything else (as mentioned previously, this has manifested as a concentration on nutrients only).

But, as any chef will tell you, every meal tells a story. And as active participants in the event, we are the characters in that story. But unlike The Truman Show, we get to write the script for our hour upon the stage. Let us embrace the many connections that empower us and not spend our time strutting and fretting about petty ingredient label minutia. 

The Study:
Longo-Silva, G; de Oliveira Lima, M; Kairny Perieira Pedrosa, A; Serenini, R; de Menezes Marinho, P; Egito de Menezes, RC. Association of largest meal timing and eating frequency with body mass index and obesity. Clinical Nutrition ESPEN. 2024. 60: 179-186.  https://doi.org/10.1016/j.clnesp.2024.01.02.

Additional Resources:
Asher G, Sassone-Corsi P. Time for food: the intimate interplay between nutrition, metabolism, and the circadian clock. Cell 2015;161(1):84e92. https://doi.org/10.1016/j.cell.2015.03.015.

Chambers L, Seidler K, Barrow M. Circadian misalignment in obesity: the role for time-restricted feeding. Clin Nutr ESPEN 2023 Oct;57:430e47. https://doi.org/10.1016/j.clnesp.2023.07.086.

Holmback I, Ericson U, Gullberg B, Wirfalt E. A high eating frequency is associated with an overall healthy lifestyle in middle-aged men and women and reduced likelihood of general and central obesity in men. Br J Nutr 2010;104(7):1065e73. https://doi.org/10.1017/S0007114510001753.

Mattson MP, Allison DB, Fontana L, Harvie M, Longo VD, Malaisse WJ, et al. Meal frequency and timing in health and disease. Proc Natl Acad Sci U S A 2014;111(47):16647e53. https://doi.org/10.1073/pnas.1413965111.

Lopez-Minguez J, Gomez-Abellan P, Garaulet M. Timing of breakfast, lunch, and dinner. Effects on obesity and metabolic risk. Nutrients 2019;11(11):2624. https://doi.org/10.3390/nu11112624.

Parr EB, Heilbronn LK, Hawley JA. A time to eat and a time to exercise. Exerc Sport Sci Rev 2020;48(1):4e10. https://doi.org/10.1249/JES.0000000000000207.

Titan SM, Bingham S, Welch A, Luben R, Oakes S, Day N, et al. Frequency of eating and concentrations of serum cholesterol in the Norfolk population of the European prospective investigation into cancer (EPIC-Norfolk): cross sectional study. BMJ 2001;323(7324):1286e8. https://doi.org/10.1136/bmj.323.7324.1286.

Zeron-Rugerio MF, Longo-Silva G, Hernaez A, Ortega-Regules AE, Cambras T, Izquierdo-Pulido M. The elapsed time between dinner and the midpoint of sleep is associated with adiposity in young women. Nutrients 2020;12(2):410. https://doi.org/10.3390/nu12020410.

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