Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee; Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.
Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.
J Acad Nutr Diet. 2023 Mar;123(3):417-426.e3. doi: 10.1016/j.jand.2022.08.119. Epub 2022 Aug 11.
Previous dietary studies and current dietary guidelines have mainly focused on dietary intake and food patterns. Little is known about the association between eating behaviors such as meal frequency, skipping and intervals, and mortality.
The objective was to examine the associations of meal frequency, skipping, and intervals with all-cause and cardiovascular disease (CVD) mortality.
This was a prospective study.
PARTICIPANTS/SETTING: A total of 24,011 adults (aged ≥40 years) who participated in the National Health and Nutrition Examination Survey 1999-2014 were included in this study. Eating behaviors were assessed using 24-hour recall. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2015.
The outcomes were all-cause and CVD mortality.
Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) of all-cause and CVD mortality.
During 185,398 person-years of follow-up period, 4,175 deaths occurred, including 878 cardiovascular deaths. Most participants ate three meals per day. Compared with participants eating three meals per day, the multivariable-adjusted HRs for participants eating one meal per day were 1.30 (95% CI 1.03 to 1.64) for all-cause mortality, and 1.83 (95% CI 1.26 to 2.65) for CVD mortality. Participants who skipped breakfast have multivariable-adjusted HRs 1.40 (95% CI 1.09 to 1.78) for CVD mortality compared with those who did not. The multivariable-adjusted HRs for all-cause mortality were 1.12 (95% CI 1.01 to 1.24) for skipping lunch and 1.16 (95% CI 1.02 to 1.32) for skipping dinner compared with those who did not. Among participants eating three meals per day, the multivariable-adjusted HR for participants with an average interval of ≤4.5 hours in two adjacent meals was 1.17 (95% CI 1.04 to 1.32) for all-cause mortality, comparing with those having a meal interval of 4.6 to 5.5 hours.
In this large, prospective study of US adults aged 40 years or older, eating one meal per day was associated with an increased risk of all-cause and CVD mortality. Skipping breakfast was associated with increased risk of CVD mortality, whereas skipping lunch or dinner was associated with increased risk of all-cause mortality. Among participant with three meals per day, a meal interval of ≤4.5 hours in two adjacent meals was associated with higher all-cause mortality.
之前的饮食研究和当前的饮食指南主要集中在饮食摄入和食物模式上。对于饮食行为（如用餐频率、跳过和间隔）与全因和心血管疾病（CVD）死亡率之间的关系，人们知之甚少。
本研究旨在探讨用餐频率、跳过和间隔与全因和 CVD 死亡率之间的关系。
这是一项前瞻性研究。
参与者/设置：共有 24011 名（年龄≥40 岁）参加了 1999-2014 年全国健康与营养调查的成年人被纳入本研究。饮食行为通过 24 小时回顾法进行评估。通过与死亡记录的链接，截至 2015 年 12 月 31 日，确定死亡和死亡的根本原因。
结局为全因和 CVD 死亡率。
使用多变量 Cox 比例风险模型来估计全因和 CVD 死亡率的调整后风险比（HR）。
在 185398 人年的随访期间，发生了 4175 例死亡，包括 878 例心血管死亡。大多数参与者每天吃三顿饭。与每天吃三顿饭的参与者相比，每天吃一顿饭的参与者的多变量调整 HR 为全因死亡率 1.30（95%CI 1.03 至 1.64），CVD 死亡率为 1.83（95%CI 1.26 至 2.65）。与不不吃早餐的参与者相比，不吃早餐的参与者的多变量调整 HR 为 CVD 死亡率 1.40（95%CI 1.09 至 1.78）。与不吃午餐相比，多变量调整 HR 为全因死亡率 1.12（95%CI 1.01 至 1.24），多变量调整 HR 为 1.16（95%CI 1.02 至 1.32）。对于每天吃三顿饭的参与者，相邻两餐的平均间隔≤4.5 小时的参与者的多变量调整 HR 为全因死亡率 1.17（95%CI 1.04 至 1.32），与间隔 4.6 至 5.5 小时的参与者相比。
在这项针对美国年龄在 40 岁或以上的成年人的大型前瞻性研究中，每天吃一顿饭与全因和 CVD 死亡率的增加有关。不吃早餐与 CVD 死亡率增加有关，而不吃午餐或晚餐与全因死亡率增加有关。在每天吃三顿饭的参与者中，相邻两餐的间隔时间≤4.5 小时与全因死亡率升高有关。
