The frequency and size of meals were a stronger determinant of weight loss or gain than the time between the first and last meal, according to new research published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
According to the senior study author Ms. Wendy L. Bennett, M.D., M.P.H., an associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore, although ‘time-restricted eating patterns’, known as intermittent fasting, are popular, rigorously designed studies have not yet determined whether limiting the total eating window during the day helps to control weight.
This study evaluated the association between time from the first meal to the last meal with weight change. Nearly 550 adults, 18 years old or older, from three health systems in Maryland and Pennsylvania with electronic health records, were enrolled in the study. Participants had at least one weight and height measurement registered.
Overall, most participants (80 percent) reported they were white adults, 12 percent self-reported as Black adults, and about 3 percent self-identified as Asian adults. Most participants reported having a college education or higher, the average age was 51 years, and the average body mass index was 30.8, which is considered obese. The average follow-up time for weight recorded in the electronic health record was 6.3 years.
Participants with a higher body mass index at enrollment were more likely to be Black adults, older, have Type 2 diabetes or high blood pressure, have a lower education level, exercise less, eat fewer fruits and vegetables, have a longer duration from last mealtime to sleep and a shorter duration from first to last meal, compared to the adults who had a lower body mass index.
The research team created a mobile application, Daily24, for participants to catalog sleeping, eating and wake-up time for each 24-hour window in real-time. Emails, text messages and in-app notifications encouraged participants to use the app as much as possible during the first month and again during “power weeks”, one week per month for the six-month intervention portion of the study.
Based on the timing of sleeping and eating each day recorded in the mobile app, researchers were able to measure the time from the first meal to the last meal each day, the time lapse from waking to the first meal, and the interval from the last meal to sleep. They calculated an average for all data from completed days for each participant.
The data analysis found:
- Meal timing was not associated with weight change during the six-year follow-up period. This includes the interval from first to last meal, from waking up to eating a first meal, from eating the last meal to going to sleep and total sleep duration.
- The total daily number of large meals (estimated at more than 1,000 calories) and medium meals (estimated at 500-1,000 calories) were each associated with increased weight over the six-year follow-up, while fewer small meals (estimated at less than 500 calories) were associated with decreasing weight.
- The average time from first to last meal was 11.5 hours, the average time from waking up to first meal measured 1.6 hours, the average time from last meal to sleep was 4 hours, and the average sleep duration was calculated at 7.5 hours.
- The study did not detect an association between meal timing and weight change in a population with a wide range of body weights.
Although the study found that meal frequency and total calorie intake were stronger risk factors for weight change than meal timing, the findings could not prove direct cause and effect, according to lead study author Di Zhao, Ph.D., an associate scientist in the division of cardiovascular and clinical epidemiology at Johns Hopkins Bloomberg School of Public Health.