Snacking between main meals is associated with a higher risk of metabolic syndrome in a Mediterranean cohort: the SUN Project (Seguimiento Universidad de Navarra)
Open accessAbstract
Objective: To evaluate the association of snacking between main meals with the risk of developing metabolic syndrome. Design: A dynamic prospective cohort study (the SUN Project; Seguimiento Universidad de Navarra). Snack consumption was evaluated using the question: ‘Do you have the habit of snacking between main meals?’ Metabolic syndrome was defined according to the updated harmonizing criteria. We estimated multivariable-adjusted relative risks (RR) of metabolic syndrome and their 95 % confidence intervals using Poisson regression models. An exploratory factor analysis was also used to identify patterns of snacking. Setting: University of Navarra, Spain. Subjects: The study included 6851 university graduates, initially free of metabolic syndrome, and followed-up them for a median of 8·3 years. Results: Among our participants, 34·6 % reported usual snacking between main meals. The cumulative incidence of metabolic syndrome was 5·1 % (9·5 % among men and 2·8 % among women). Snacking between main meals was significantly associated with higher risk for developing metabolic syndrome after multivariable adjustment (RR=1·44; 95 %CI 1·18, 1·77). Higher adherence to an ‘unhealthy snacking pattern’ was also independently associated with increased incidence of metabolic syndrome (fourth quartile of adherence compared with non-snacking: RR=1·68; 95 % CI 1·23, 2·29; P for trend <0·001). Conclusions: Our findings suggest that avoidance of snacking between main meals can be included among the preventive approaches to reduce the risk of metabolic syndrome development, especially when snacks contain foods of poor nutritional quality.
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Two randomised controlled intervention studies showed that consuming meals regularly for 2 weeks v. an irregular meal pattern led to beneficial impact on cardiometabolic risk factors as lower peak insulin, lower fasting total and LDL-cholesterol, both in lean and obese women.
“This was supported by two randomised controlled intervention studies showing that consuming meals regularly for 2 weeks v. an irregular meal pattern, led to beneficial impact on cardiometabolic risk factors as lower peak insulin, lower fasting total and LDL-cholesterol, both in lean and obese women.”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
Farshchi et al. conducted two randomised cross-over dietary intervention studies investigating the impact of irregular meal frequency pattern on circulating lipids, insulin, glucose and uric acid in nine healthy lean women and ten healthy obese women.
“Farshchi et al. conducted two randomised cross-over dietary intervention studies investigating the impact of irregular meal frequency pattern on circulating lipids, insulin, glucose and uric acid in nine healthy lean women (42) and ten healthy obese women (43) .”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
These randomised controlled trials showed that an irregular eating frequency seems to negatively impact fasting lipid and postprandial insulin profiles and thermogenesis.
“These randomised controlled trials showed that an irregular eating frequency seem to negatively impact fasting lipid and postprandial insulin profiles and thermogenesis, confirming the importance of meal patterns in influencing carbohydrate and lipid metabolism in addition to the amount and composition of food consumed.”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
In lean women, fasting glucose and insulin concentrations were not affected by meal frequency, but peak insulin and area under the curve responses to a test meal were higher after the irregular meal routine compared with the regular meal routine.
“The first study in lean women (BMI 23•7 (SD 7•4) kg/m 2 ) showed that fasting glucose and insulin concentrations were not affected by meal frequency, but peak insulin and area under the curve responses to a test meal were higher after the irregular meal routine compared with the regular meal routine (42) .”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
Irregular meal frequency was associated with higher fasting total and LDL-cholesterol (P < 0•01) in lean women.
“Irregular meal frequency was also associated with higher fasting total and LDL-cholesterol (P < 0•01) suggesting that the irregular meal routine appeared to produce a degree of impaired insulin resistance and higher fasting lipid profiles.”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
Meal irregularity could also be interpreted as being related to meal frequency, as observed in the studies by Farshchi et al., making the distinction between meal irregularity and meal frequency somewhat distorted.
“However, meal irregularity could also be interpreted as being related to meal frequency, as was observed in the studies by Farshchi et al. (42,43) making the distinction between meal irregularity and meal frequency somewhat distorted.”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
Meal irregularity is closely inter-linked with meal frequency.
“Whilst the present paper was not specifically focused on meal frequency and cardiometabolic risk factors, meal irregularity is closely inter-linked with meal frequency, as could also be observed in the randomised controlled trials by Farshchi et al. (42,43) .”
From Meal irregularity and cardiometabolic consequences: results from observational and intervention studies (2016) · cites this paper as [42]
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Cites
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C. (2009) · Circulation · doi:10.1161/circulationaha.109.192644 · Cited by 14,860 · see citing works
Willett, W. C. (1998) · doi:10.1093/acprof:oso/9780195122978.001.0001 · Cited by 4,541 · see citing works
Adherence to a Mediterranean diet and survival in a Greek population
Trichopoulou, A., Costacou, T., Bamia, C., & Trichopoulos, D. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa025039 · Cited by 4,397 · see citing works
Grundy, S. M. (2008) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.107.151092 · Cited by 1,571 · see citing works
Angiogenesis and Inflammation in Peritoneal Dialysis: The Role of Adipocytes
Shi, J., Yu, M., & Sheng, M. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000476017 · Cited by 1,403 · see citing works
Martínez‐González, M. Á., López-Fontana, C. M., Cenarruzabeitia, J. J. V., Sánchez‐Villegas, A., & Martínez, J. A. (2005) · Public Health Nutrition · doi:10.1079/phn2005745 · Cited by 581 · see citing works
Klein, S., Allison, D. B., Heymsfield, S. B., Kelley, D. E., Leibel, R. L., Nonas, C., & Kahn, R. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/85.5.1197 · Cited by 560 · see citing works
Effects of lifestyle modification on metabolic syndrome: a systematic review and meta-analysis
Yamaoka, K., & Tango, T. (2012) · BMC Medicine · doi:10.1186/1741-7015-10-138 · Cited by 409 · see citing works
Reproducibility of an FFQ validated in Spain
de la Fuente‐Arrillaga, C., Ruiz, Z. V., Bes‐Rastrollo, M., Sampson, L., & Martínez‐González, M. Á. (2010) · Public Health Nutrition · doi:10.1017/s1368980009993065 · Cited by 401 · see citing works
Self-citationDealing With Missing Outcome Data in Randomized Trials and Observational Studies
Groenwold, R. H. H., Donders, A. R. T., Roes, K. C. B., Harrell, F. E., & Moons, K. G. M. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kwr302 · Cited by 398 · see citing works
Bertéus Forslund, H., Torgerson, J. S., Sjöström, L., & Lindroos, A. K. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0802950 · Cited by 332 · see citing works
The Prevalence of Metabolic Syndrome in Various Populations
Kolovou, G. D., Anagnostopoulou, K. K., Salpea, K. D., & Mikhailidis, D. P. (2007) · The American Journal of the Medical Sciences · doi:10.1097/maj.0b013e318065c3a1 · Cited by 248 · see citing works
Cohort profile: The ‘Seguimiento Universidad de Navarra’ (SUN) study
Seguí‐Gómez, M., de la Fuente, C., Ruiz, Z. V., de Irala, J., & Martínez‐González, M. Á. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyl223 · Cited by 217 · see citing works
Snacks as an element of energy intake and food consumption
Ovaskainen, M.-L., Reinivuo, H., Tapanainen, H., Hannila, M.-L., Korhonen, T., & Pakkala, H. (2006) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1602343 · Cited by 178 · see citing works
Effects of snacks on energy intake: An evolutionary perspective
de Graaf, C. (2006) · Appetite · doi:10.1016/j.appet.2006.02.007 · Cited by 163 · see citing works
Mediterranean Diet and Stroke: Objectives and Design of the SUN Project
Martínez‐González, M. Á., Sánchez‐Villegas, A., de Irala, J., Martí, A., & Martínez, J. A. (2002) · Nutritional Neuroscience · doi:10.1080/10284150290007047 · Cited by 147 · see citing works
Dietary strategies to reduce metabolic syndrome
Andersen, C. J., & Fernández, M. L. (2013) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-013-9251-y · Cited by 142 · see citing works
The Role of Snacking in Energy Balance: a Biobehavioral Approach,
Chapelot, D. (2011) · The Journal of Nutrition · doi:10.3945/jn.109.114330 · Cited by 126 · see citing works
McDonald, C. M., Baylín, A., Arsenault, J. E., Mora‐Plazas, M., & Villamor, E. (2008) · Journal of Nutrition · doi:10.3945/jn.108.098111 · Cited by 124 · see citing works
Obesity, metabolic syndrome, adipocytes and vascular function: A holistic viewpoint
Achike, F. I., To, N. P., Wang, H., & Kwan, C. (2010) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/j.1440-1681.2010.05460.x · Cited by 114 · see citing works
Fernandez-Berges, D. J., de León, A. C., Sanz, H., Elosúa, R., Guembe, M. J., Alzamora, M. T., Vega-Alonso, T., Félix-Redondo, F. J., Ortiz-Marrón, H., Rigo, F., et al. (2012) · Revista Española de Cardiología · doi:10.1016/j.recesp.2011.10.015 · Cited by 111 · see citing works
Marmonier, C., Chapelot, D., Fantino, M., & LOUIS-SYLVESTRE, J. (2002) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.3.518 · Cited by 103 · see citing works
Fernandez-Berges, D. J., de León, A. C., Sanz, H., Elosúa, R., Guembe, M. J., Alzamora, M. T., Vega-Alonso, T., Félix-Redondo, F. J., Ortiz-Marrón, H., Rigo, F., et al. (2012) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2011.10.017 · Cited by 95 · see citing works
Bes‐Rastrollo, M., Sánchez‐Villegas, A., Basterra-Gortari, F. J., Núñez-Córdoba, J. M., Toledo, E., & Serrano-Martínez, M. (2009) · Clinical Nutrition · doi:10.1016/j.clnu.2009.08.017 · Cited by 90 · see citing works
Self-citationJääskeläinen, A., Schwab, U., Kolehmainen, M., Pirkola, J., Järvelin, M.-R., & Laitinen, J. (2013) · Nutrition, Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2012.07.006 · Cited by 75 · see citing works
Thorp, A. A., McNaughton, S. A., Owen, N. G., & Dunstan, D. W. (2013) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-10-96 · Cited by 61 · see citing works
Validation of metabolic syndrome using medical records in the SUN cohort
Barrio-López, M. T., Bes‐Rastrollo, M., Beunza, J. J., Fernández‐Montero, A., García–López, M., & Martínez‐González, M. Á. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-867 · Cited by 50 · see citing works
Self-citationValidación de los componentes del síndrome metabólico autodeclarados en un estudio de cohortes
Fernández‐Montero, A., Beunza, J. J., Bes‐Rastrollo, M., Barrio, M. T., de la Fuente‐Arrillaga, C., Moreno‐Galarraga, L., & Martínez‐González, M. Á. (2011) · Gaceta Sanitaria · doi:10.1016/j.gaceta.2011.02.009 · Cited by 45 · see citing works
Self-citationMirmiran, P., Bahadoran, Z., Delshad, H., & Azizi, F. (2013) · Nutrition · doi:10.1016/j.nut.2013.09.014 · Cited by 40 · see citing works
Moschonis, G., Mavrogianni, C., Karatzi, K., Iatridi, V., Chrousos, G. P., Lionis, C. D., & Μanios, Y. (2012) · European Journal of Nutrition · doi:10.1007/s00394-012-0424-3 · Cited by 31 · see citing works
The global obesity epidemic: Snacking and obesity may start with free meals during infant feeding
Erlanson‐Albertsson, C., & Zetterström, R. H. (2005) · Acta Paediatrica · doi:10.1080/08035250500323780 · Cited by 30 · see citing works
Vergetaki, A., Linardakis, M. K., Papadaki, A., & Kafatos, A. (2011) · Appetite · doi:10.1016/j.appet.2011.05.309 · Cited by 29 · see citing works
Components of the Metabolic Syndrome and Lifestyle Factors in Japanese Male Workers
Kawada, T., Okada, K., & Amezawa, M. (2008) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2008.0020 · Cited by 18 · see citing works
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Research works printed but not linked: 1
- Gordis L (2014) Epidemiology, 5th ed. Philadelphia, PA: Elsevier Saunders.
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Pot, G. K., Almoosawi, S., & Stephen, A. M. (2016) · Proceedings of the Nutrition Society · doi:10.1017/s0029665116000239 · Cited by 134 · see citing works
- Authors
- Pimenta, A. M., Bes-Rastrollo, M., Gea, A., Sayón-Orea, C., Zazpe, I., Lopez-Iracheta, R., & Martinez-Gonzalez, M. A.
- Affiliations
- Universidade Federal de Minas Gerais (BR)
- Universidad de Navarra (ES)
- Corresponding author
- Pimenta, Adriano M
- Venue
- Public Health Nutrition
- Publisher
- Cambridge University Press (CUP)
- Published
- 2015-05-11
- Volume
- 19
- Issue
- 4
- Pages
- 658-666
- ISSN
- 1368-9800 (ISSN-L)
- 1475-2727
- PMC
- PMC10270996
- OpenAlex
- W2255639336
- Cited by
- 18
- References
- 33
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 1 · 2017: 2 · 2016: 2
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Public Health Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Deposito Adademico Digital Universidad De Navarra (University of Navarra) (submittedVersion, cc-by)
- Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Universidad de Navarra (PI14/01798, PI13/00615, G03/140, 45/2011, 122/2014, PI14/01668, PI10/02658)
- European Regional Development Fund (122/2014, PI10/02993, PI14/01798, (RD 06/0045, PI10/02658, G03/140, PI13/00615, PI14/1764, PI14/01668, 45/2011)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- snacking, metabolic syndrome, dietary habits, SUN Project, university graduates, preventive nutrition, Mediterranean diet
- MeSH terms
- Adult, Diet, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Spain, Universities, Incidence, Metabolic Syndrome, Snacks
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