Kahleova Hana, Lloren Jan Irene, Mashchak Andrew, Hill Martin, Fraser Gary E
School of Public Health, Loma Linda University, Loma Linda, CA.
Institute for Clinical and Experimental Medicine, Prague, Czech Republic; and.
J Nutr. 2017 Sep;147(9):1722-1728. doi: 10.3945/jn.116.244749. Epub 2017 Jul 12.
Scientific evidence for the optimal number, timing, and size of meals is lacking. We investigated the relation between meal frequency and timing and changes in body mass index (BMI) in the Adventist Health Study 2 (AHS-2), a relatively healthy North American cohort. The analysis used data from 50,660 adult members aged ≥30 y of Seventh-day Adventist churches in the United States and Canada (mean ± SD follow-up: 7.42 ± 1.23 y). The number of meals per day, length of overnight fast, consumption of breakfast, and timing of the largest meal were exposure variables. The primary outcome was change in BMI per year. Linear regression analyses (stratified on baseline BMI) were adjusted for important demographic and lifestyle factors. Subjects who ate 1 or 2 meals/d had a reduction in BMI per year (in kg · m · y) (-0.035; 95% CI: -0.065, -0.004 and -0.029; 95% CI: -0.041, -0.017, respectively) compared with those who ate 3 meals/d. On the other hand, eating >3 meals/d (snacking) was associated with a relative increase in BMI ( < 0.001). Correspondingly, the BMI of subjects who had a long overnight fast (≥18 h) decreased compared with those who had a medium overnight fast (12-17 h) ( < 0.001). Breakfast eaters (-0.029; 95% CI: -0.047, -0.012; < 0.001) experienced a decreased BMI compared with breakfast skippers. Relative to subjects who ate their largest meal at dinner, those who consumed breakfast as the largest meal experienced a significant decrease in BMI (-0.038; 95% CI: -0.048, -0.028), and those who consumed a big lunch experienced a smaller but still significant decrease in BMI than did those who ate their largest meal at dinner. Our results suggest that in relatively healthy adults, eating less frequently, no snacking, consuming breakfast, and eating the largest meal in the morning may be effective methods for preventing long-term weight gain. Eating breakfast and lunch 5-6 h apart and making the overnight fast last 18-19 h may be a useful practical strategy.
目前缺乏关于最佳用餐次数、时间和分量的科学证据。我们在基督复临安息日会健康研究2（AHS - 2）中调查了用餐频率和时间与体重指数（BMI）变化之间的关系，该研究对象为相对健康的北美人群队列。分析使用了美国和加拿大基督复临安息日会教堂50660名年龄≥30岁成年成员的数据（平均±标准差随访时间：7.42±1.23年）。每日用餐次数、夜间禁食时长、早餐摄入情况以及最大餐的用餐时间为暴露变量。主要结局是每年BMI的变化。线性回归分析（按基线BMI分层）对重要的人口统计学和生活方式因素进行了校正。与每天吃三餐的人相比，每天吃1或2餐的人每年BMI下降（以kg·m·年计）（分别为-0.035；95%置信区间：-0.065，-0.004和-0.029；95%置信区间：-0.041，-0.017）。另一方面，每天用餐超过3次（吃零食）与BMI相对增加相关（<0.001）。相应地，与夜间禁食时长为中等水平（12 - 17小时）的人相比，夜间禁食时间长（≥18小时）的人的BMI下降（<0.001）。吃早餐的人（-0.029；95%置信区间：-0.047，-0.012；<0.001）与不吃早餐的人相比，BMI有所下降。与晚餐吃最大餐的人相比，早餐吃最大餐的人BMI显著下降（-0.038；95%置信区间：-0.048，-0.028），午餐吃大餐的人BMI下降幅度虽小但仍显著低于晚餐吃最大餐的人。我们的研究结果表明，在相对健康的成年人中，减少用餐频率、不吃零食、吃早餐以及在早上吃最大餐可能是预防长期体重增加的有效方法。早餐和午餐间隔5 - 6小时进食，夜间禁食持续18 - 19小时可能是一个有用的实用策略。
