Meal frequency and energy balance

Br J Nutr. 1997 Apr;77 Suppl 1:S57-70.
Meal frequency and energy balance.

Bellisle F, McDevitt R, Prentice AM.

INSERM U341, Hotel Dieu de Paris, France.
CONCLUSIONS AND PRIORITIES FOR FUTURE RESEARCH

We conclude that there is robust evidence from several independent laboratories to refute the hypothesis that feeding frequency is a significant determinant of energetic efficiency in human subjects when assessed over 24 h or longer. Consequently, feeding frequency has no significant impact on the rate of weight loss during energy restriction. We further conclude that the epidemiological studies which have suggested that nibbling is associated with leanness are extremely vulnerable to methodological errors which may generate spurious relationships due to dietary under-reporting and post hoc alterations in eating patterns in response to weight gain. Although these may not totally invalidate the cross-sectional studies, they highlight the need for considerable caution in interpreting the results and point to the need for a more critical analysis in the future.

Since we conclude that feeding frequency has no discernible effect on 24 h energy expenditure, then any putative effects on regulation of body weight must be mediated through effects on the intake side of the energy balance equation. Aspects of this question are reviewed elsewhere in this workshop (de Castro, 1997; Gatenby, 1997), but may also require fresh experimental approaches. Future research might usefully investigate the effects of meal frequency on spontaneous food selection and on the regulation of energy intake. This should address both the immediate effects of high and low meal frequencies, and the downstream effects on later meals. One prospective study in hyperlipidaemic patients already suggests that recommendations to increase or decrease meal frequency are accompanied by concomitant changes in overall energy intake and in body weight (King & Gibney, 1997). Interactions between meal frequency and habitual levels of physical activity might also be important. The difficulties of such research with respect to the confounding effects of under-reporting should not be underestimated.

In the field of eating disorders there is emerging interest in the potential interaction between eating frequency and the development and treatment of eating disorders. S68 F. BELLISLE ET AL.

Cognitive behavioural therapies for bulimia stress the importance of establishing regular meal patterns, and some practitioners are recommending high snack frequencies as a means of inhibiting bingeing. There is a need for a formal appraisal of the evidence base for such interventions.


Any decisions regarding dietary advice in favour of the adoption of nibbling or gorging meal patterns should be dominated by a consideration of the effects on carbohydrate and lipid metabolism (Jenkins, 1997; Mann, 1997), rather than on energy expenditure, where a prudent analyst would probably conclude that the metabolic effects are neutral."

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