Frequency of eating and concentrations of serum cholesterol in the Norfolk population of the European prospective investigation into cancer (EPIC-Norfolk): cross sectional study
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Objectives: To examine the relation between self reported eating frequency and serum lipid concentrations in a free living population. Design: Cross sectional population based study. Setting: Norfolk, England. Participants: 14 666 men and women aged 45–75 years from the Norfolk cohort of the European prospective investigation into cancer (EPIC-Norfolk). Main outcome measures: Concentrations of blood lipids. Results: Mean concentrations of total cholesterol and low density lipoprotein cholesterol decreased in a continuous relation with increasing daily frequency of eating in men and women. No consistent relation was observed for high density lipoprotein cholesterol, body mass index, waist to hip ratio, or blood pressure. Mean cholesterol concentrations differed by about 0.25 mmol/l between people eating more than six times a day and those eating once or twice daily; this difference was reduced to 0.15 mmol/l after adjustment for possible confounding variables, including age, obesity, cigarette smoking, physical activity, and intake of energy and nutrients (alcohol, fat, fatty acids, protein, and carbohydrate). Conclusions: Concentrations of total cholesterol and low density lipoprotein cholesterol are negatively and consistently associated with frequency of eating in a general population. The effects of eating frequency on lipid concentrations induced in short term trials in animals and human volunteers under controlled laboratory conditions can be observed in a free living general population. We need to consider not just what we eat but how often we eat. What is already known on this topic: Studies in animals and small human trials indicate that eating frequency is inversely related to serum lipid concentrations Few studies have examined this in a free living population under no dietary restrictions What this study adds: In a free living population increased eating frequency was negatively and significantly associated with concentrations of total cholesterol and low density lipoprotein cholesterol This association was still present after adjustment for body mass index, physical activity, cigarette smoking, and dietary intake Mean age adjusted cholesterol concentrations differed by 0.25 mmol/l between people eating more than six times a day and those eating less than twice daily
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Previous epidemiological studies have shown lipid profiles become more favorable with increasing number of meals.
“Previous epidemiological studies have shown lipid profiles to become more favorable with increasing number of meals (5)(6)(7).”
From Eating Meals Irregularly: A Novel Environmental Risk Factor for the Metabolic Syndrome (2008) · cites this paper as [7]
Sex and several psychosocial and behavioural characteristics are related to energy misreporting, including incomplete recordkeeping by subjects.
“Sex and several psychosocial and behavioural characteristics are related to energy misreporting, including incomplete recordkeeping by subjects (26) .”
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Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423 · see citing works
Antihyperlipidemic and Biochemical Activities of Mcy Protein in Streptozotocin Induced Diabetic Rats
Marella, S., Maddirela, D. R., Badri, K. R., Kumar, M. V. J., & Chippada, A. R. (2015) · Cellular Physiology and Biochemistry · doi:10.1159/000373954 · Cited by 5,938 · see citing works
Day, N., Oakes, S., Luben, R., Khaw, K., Bingham, S., Welch, A., & Wareham, N. (1999) · Nature · doi:10.17863/cam.89388 · Cited by 780 · see citing works
Self-citationDietary lipids and blood cholesterol: quantitative meta-analysis of metabolic ward studies
Clarke, R. C., Frost, C. D., Collins, R., Appleby, P. N., & Peto, R. (1997) · BMJ · doi:10.1136/bmj.314.7074.112 · Cited by 645 · see citing works
Bingham, S. (1997) · International Journal of Epidemiology · doi:10.1093/ije/26.suppl_1.s137 · Cited by 634 · see citing works
Self-citationChen, Z., Peto, R., Collins, R., MacMahon, S. W., Lu, J., & Li, W. (1991) · BMJ · doi:10.1136/bmj.303.6797.276 · Cited by 537 · see citing works
Nibbling versus gorging: metabolic advantages of increased meal frequency
Jenkins, D. J. A., Wolever, T. M. S., Vuksan, V., Brighenti, F., Cunnane, S. C., Rao, A. V., Jenkins, A. L., Buckley, G., Patten, R., Singer, W., et al. (1989) · New England Journal of Medicine · doi:10.1056/nejm198910053211403 · Cited by 467 · see citing works
EPIC-Norfolk: Study design and characteristics of the cohort
Day, N., Oakes, S., Luben, R., Khaw, K., Bingham, S., Welch, A., & Wareham, N. (1999) · UEA Digital Repository (University of East Anglia) · Cited by 261 · see citing works
Self-citationChanges in body composition attendant on force feeding
Cohn, C., & Joseph, D. (1959) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1959.196.5.965 · Cited by 208 · see citing works
Cohn, C., & Joseph, D. (1960) · PubMed · Cited by 179 · see citing works
Meal Frequency—A Possible Factor in Human Pathology
FAÁBRY, P., & Tepperman, J. (1970) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/23.8.1059 · Cited by 179 · see citing works
Edelstein, S., Barrett-Connor, E., Wingard, D., & Cohn, B. (1992) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/55.3.664 · Cited by 136 · see citing works
Effect of nibbling versus gorging on serum lipids in man
GWINUP, G., BYRON, R. C., ROUSH, W. H., KRUGER, F. A., & HAMWI, G. J. (1963) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/13.4.209 · Cited by 115 · see citing works
Effect of isoenergetic intake of three or nine meals on plasma lipoproteins and glucose metabolism
Arnold, L., Ball, M., Duncan, A., & Mann, J. (1993) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/57.3.446 · Cited by 102 · see citing works
Serum cholesterol and ischaemic heart disease
Wald, N., & Law, M. R. (1995) · Atherosclerosis · doi:10.1016/0021-9150(95)90067-5 · Cited by 97 · see citing works
Health Survey for England 1994
Colhoun, H. M., & Prescott-Clarke, P. (1994) · Cited by 88 · see citing works
MEAL FREQUENCY AND ISCHÆMIC HEART-DISEASE
Fábry, P., Fodor, J., Hejl, Z., Geizerová, H., & Balcarová, O. (1968) · The Lancet · doi:10.1016/s0140-6736(68)92622-6 · Cited by 53 · see citing works
McGrath, S., & Gibney, M. J. (1994) · PubMed · Cited by 46 · see citing works
Meal frequency; does it determine postprandial lipaemia?
Murphy, M. C., Chapman, C., Lovegrove, J. A., Isherwood, S. G., Morgan, L., Wright, J. W., & Williams, C. M. (1996) · PubMed · Cited by 42 · see citing works
Metabolic effects of continuous feeding
Wolever, T. M. S. (1990) · Metabolism · doi:10.1016/0026-0495(90)90306-w · Cited by 36 · see citing works
Does Nibbling or Grazing Protect the Peripheral Arteries from Atherosclerosis?
Powell, J. T., Franks, P. J., & Poulter, N. R. (1999) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/204748739900600104 · Cited by 12 · see citing works
Serum cholesterol and ischaemic heart disease
Wald, N. (1995) · Atherosclerosis · doi:10.1016/0021-9150(95)05755-2 · Cited by 12 · see citing works
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Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality
Leech, R. M., Worsley, A., Timperio, A., & McNaughton, S. A. (2015) · Nutrition Research Reviews · doi:10.1017/s0954422414000262 · Cited by 379 · 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
Meal and Snack Patterns Are Associated with Dietary Intake of Energy and Nutrients in US Adults
Kerver, J. M., Yang, E. J., Obayashi, S., Bianchi, L., & Song, W. O. (2006) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2005.09.045 · Cited by 232 · see citing works
Eating Meals Irregularly: A Novel Environmental Risk Factor for the Metabolic Syndrome
Sierra‐Johnson, J., Undén, A., Linestrand, M., Rosell, M., Sjogren, P., Kolak, M., De Faire, U., Fisher, R. M., & Hellénius, M. (2008) · Obesity · doi:10.1038/oby.2008.203 · Cited by 155 · see citing works
Characterizing eating patterns: a comparison of eating occasion definitions
Leech, R. M., Worsley, A., Timperio, A., & McNaughton, S. A. (2015) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.115.114660 · Cited by 133 · see citing works
Holmbäck, I., Ericson, U., Gullberg, B., & Wirfält, E. (2010) · British Journal of Nutrition · doi:10.1017/s0007114510001753 · Cited by 120 · see citing works
Eating frequency and body fatness in middle-aged men
Ruidavets, J., Bongard, V, Bataille, V, Gourdy, P., & Ferrières, J. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802143 · Cited by 97 · see citing works
Kulovitz, M. G., Kravitz, L. R., Mermier, C., Gibson, A. L., Conn, C. A., Kolkmeyer, D., & Kerksick, C. M. (2014) · Nutrition · doi:10.1016/j.nut.2013.08.009 · Cited by 55 · see citing works
Wennberg, M., Gustafsson, P. E., Wennberg, P., & Hammarström, A. (2016) · Public Health Nutrition · doi:10.1017/s1368980015001445 · Cited by 53 · see citing works
Alencar, M. K., Beam, J. R., McCormick, J. J., White, A. C., Salgado, R. M., Kravitz, L. R., Mermier, C. M., Gibson, A. L., Conn, C. A., Kolkmeyer, D., et al. (2015) · Nutrition Research · doi:10.1016/j.nutres.2015.03.003 · Cited by 32 · see citing works
- Authors
- Titan, S. M. O., Bingham, S., Welch, A., Luben, R., Oakes, S., Day, N., & Khaw, K.-T.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Khaw, Kay-Tee
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2001-12-01
- Volume
- 323
- Issue
- 7324
- Pages
- 1286.1
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC60303
- OpenAlex
- W2156340622
- Cited by
- 112
- References
- 22
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 8 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 2 · 2018: 1 · 2017: 6 · 2016: 9 · 2015: 6 · 2014: 5 · 2013: 10 · 2012: 3
- FWCI
- 0.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Funders
- Wellcome Trust
- British Heart Foundation
- Stroke Association
- European Commission
- Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- meal frequency, serum cholesterol, total cholesterol, LDL cholesterol, HDL cholesterol, serum lipids, dietary habits, free-living population, EPIC-Norfolk cohort
- MeSH terms
- Aged, Blood Pressure, Body Constitution, Cholesterol, Cross-Sectional Studies, Feeding Behavior, Female, Humans, Cholesterol, LDL, Male, Middle Aged, Prospective Studies, Sex Factors, Confounding Factors, Epidemiologic, Body Mass Index
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