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Does Eating Frequent Meals influence my Cholesterol or Blood Glucose Levels?

Recently, evidence has come out that has caused me to question how I view my approach to healthy eating.  One of my first blog posts on here was my 12 Essential Tips for Healthy Eating.  The first tip on my list was to eat frequent meals every 2 to 3 hours (5 to 6 meals a day).

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At the time of writing that post I was looking at this approach through the eyes of someone who is actively exercising,  training for sports, pursuing self improvement or for health benefits.  Providing the body the energy for recuperation, muscle growth but at the same time limiting spikes in blood sugar.  Admittedly, this was based on what other people have said and not necessarily what I have learned from the research.  So I decided to do some quick  research on the subject to see what the research has been finding.  I soon came to realize that asking such a blanket statement would result in lots of hours searching for information but with little focus.  So I asked myself the question. What is the effect on meal frequency on blood glucose, insulin, LDL, HDL and cholesterol.This was done since many of the papers I was finding were dealing with this subject.

Here is what some of the research is saying on meal frequency and it’s effects on blood glucose, insulin, LDL, HDL and cholesterol:

Nibbling versus Gorging: Metabolic Advantages of Increased Meal Frequency

David J.A. Jenkins, M.D., Ph.D., Thomas M.S. Wolever, M.D.., Ph.D., Vladimir Vuksan, Ph.D., Furio Brighenti, Ph.D., Stephen C. Cunnane, Ph.D., A. Venketeshwer Rao, Ph.D., Alexandra L. Jenkins, R.P.DT., Gloria Buckley, M.SC, Robert Patten, M.D., William Singer, M.B., B.S., Paul Corey, Ph.D., and Robert G. Josse, M.B., B.S. N Engl J Med 1989; 321:929-934  October 5, 1989
 
The authors took seven men and randomly split them into two groups (nibbling and gorging groups).  They found that the frequent nibbling group (17 snacks a day), versus the “gorging” group (3 meals a day) resulted in reduced fasting serum concentrations of total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B.  They also found that mean blood glucose level and serum concentrations of free fatty acids, 3-hydroxybutyrate, and triglyceride were the same between the groups.  The nibbling group resulted in a  27.9±6.3 percent  reduction in serum insulin levels, 20.2 ±5.6 percent  reduction in C-peptide levels and 17.3±5.9 percent reduction in urinary cortisol excretion compared to the gorging group.
 

Effects of nibbling and gorging on lipid profiles, blood glucose and insulin levels in healthy subjects. 

Rashidi MR, Mahboob S, Sattarivand R.Department of Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Saudi Med J. 2003 Sep;24(9):945-8.

In this study there were 15 healthy male subjects.  For two weeks they consumed a 3 meal a day diet for two weeks and then 3 weeks later they consumed a 9 snacks a day diet for two weeks. The others found that the nibbling diet resulted in an increase in blood glucose and a decrease in insulin levels. Total cholesterol, triglyceride, low-density lipoprotein (LDL) and lipoprotein (a) were lower but only lipoprotein (a) was significantly less.  There was also an insignificant increase in high-density lipoprotein (HDL).

 
Department of Human Nutrition, University of Otago, Dunedin, New Zealand.Am J Clin Nutr. 1993 Mar;57(3):446-51.
 
The authors took 19 healthy men/women and had them consume their usual diet as either 3 or 9 meals a day. The 9 meals per day significantly reduced fasting plasma total cholesterol, LDL, and HDL.  There was no change in body weight, fasting triglycerides, apolipoproteins A-I and B, and LDL-HDL cholesterol levels.  There was also no difference in C peptide-creatinine and insulin-glucose levels.
 

Arnold L, Ball M, Mann J.Department of Human Nutrition, University of Otago, Dunedin, New Zealand.Atherosclerosis. 1994 Aug;108(2):167-74.

The authors of this study  took 16 male/females, with high cholesterol levels, and randomly put them on a 3 meal a day or a 9 meal a day isocaloric diet for 4 weeks.  They found that no significant diferences in fasting cholesterol levels, and LDL-C levels.  There was no significant difference in triglyceride or insulin levels in response to a high fat meal.  There was also no difference in C-peptide levels between the groups

 

Metabolic advantages of spreading the nutrient load: effects of increased meal frequency in non-insulin-dependent diabetes.

The authors took 11 non-insulin-dependent diabetics and had them consume 13 snacks (nibbling diet) on one day. On another day, the same people consumed 3 meals plus a snack. The others compared the two and found that the nibbling diet reduced mean blood glucose, serum insulin, C peptide concentrations and triglycerides.  The concentrations of free fatty acids, 3-hydroxybutyrate and insulin-sensitive branched-chain amino acids were similar.

Effect of meal frequency on blood glucose, insulin, and free fatty acids in NIDDM subjects. 

Bertelsen J, Christiansen C, Thomsen C, Poulsen PL, Vestergaard S, Steinov A, Rasmussen LH, Rasmussen O, Hermansen K. Diabetes Care. 1993 Jan;16(1):4-7.

The authors of this study took 12 non insulin dependent older diabetics.They were randomly placed into two groups (2 large meal group and 6 small meal groups) and observed over an 8 hour period.  They received the same number of calories and similar composition.  At the end of the 8 hour period and intravascular glucose tolerance test was performed.  The authors found that the two large meal group had an 84% greater maximum amplitude of glucose changes as well as higher insulin response.

Effect of meal frequency on glucose and insulin excursions over the course of a day

Michael E. Holmstrup, Christopher M. Owens, Timothy J. Fairchild, Jill A. Kanaley

Received 7 July 2010; accepted 5 October 2010. published online 25 October 2010.

The authors took 12 people and had them eat 3 different diets (3 high glucose meals per day, 6 high glucose meals per day and 6 high protein meals in a day).  They found that the 6 high glucose meals per day resulted in a high blood glucose level and insulin levels over the entire day relative to the 3 glucose meals per day. The 6 high protein meals per day resulting in lower levels of glucose and insulin levels relative to the 3 high glucose meals per day.

Dr Notley’s Thoughts:

Based on these few articles, I can say that there appears to be some benefit to eating multiple meals/snacks throughout the day. There is some evidence that multiple meals may result in a reduction of cholesterol levels, glucose, insulin and C-peptide levels as compared to isocaloric meals of 2 or 3 times a day.  This effect is not seen in all populations though and thus making a blanket statement on the benefits/detriments of multiple meal consumption should be based on specific populations.

Another thought to ponder is, what was the composition of each of the meals in these papers? How much protein, carbohydrates, and fats where there? What types of protein, carbohydrates and fats where there?  Standardizing the food composition may allow us to have a better understanding of multiple meals affects on cholesterol, insulin and glucose levels (at least for that type of food composition).

The last research paper appears to have opposite results compared to the other research papers discussed but the difference was that the food composition changed.  

Another thought I had was, how realistic is it to ask a person to consume 9 to 17 snacks in a day. Maybe we need to see research on more realistic meal frequency like 5 to 6 meals a day.

This is obviously not a complete review of the literature but at least it has given me a better understanding of multiple meals and their effects.

I hope that these posting helps you become a little more informed on this subject.  If you find any other research papers feel free to leave the URL in the comment section below so that we can all learn more.

Have a Great Week

Dr Notley

Originally posted on May 17, 2022 @ 4:40 pm

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