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It’s not just what you eat, but when and how often you eat that can influence your overall health.

Missing breakfast, and indulging in “emotional” eating patterns can increase the risk of cardiovascular diseases, according to a statement published by the American Heart Association in the journal Circulation.

Authors of the statement reviewed current epidemiological and clinical evidence on how meal timing and meal frequency can influence CVD, and found that planning out meals and snacks throughout the day, and consuming a larger portion of your total calorie intake earlier in the day could help prevent heart conditions.

One study referenced in the review found that Americans’ consumption of all three standard meals (breakfast, lunch, dinner) has declined in the last 40 years. In the 1970s, 73 percent of men ate all three meals, as opposed to 59 percent in 2010. Women saw a similar reduction, from 75 percent of women in the 1970s to 63 percent in 2010.

But failing to consume breakfast on a daily basis seemed to have the most impact on overall health. 

Although conventional wisdom considers breakfast to be the most important meal of the day, 20 to 30 percent of American adults skip out on it.

The lack of breakfast consumption among U.S. adults has paralleled the increase in obesity rates. The Bogalusa Heart Study, which included more than 500 men and women ranging in age from 19 to 28, showed that 74 percent of people who miss breakfast failed to meet two-thirds of the Recommended Dietary Allowance for vitamins and minerals, compared to 41 percent who eat breakfast.

Other studies from around the globe have also demonstrated a link between skipping breakfast and a higher body mass index (BMI). One such study, conducted from 1999 to 2002 found that young adults (ages 20 to 39) who ate ready-to-eat cereal were 31 percent less likely to be overweight or obese, and 39 percent less likely to have abdominal obesity.

In several cross-sectional studies, daily breakfast eaters were less likely to have CVD risk factors.

Mindful eating, or planning out meals and snacks throughout the day is more beneficial than an impulsive or emotional approach, according to the authors.

Based on their findings, the authors recommend distributing calories over a certain portion of the day – from 7am to 8pm, for example. Consuming a larger portion of total daily calories earlier in the day, like having a heartier breakfast instead of dinner, was also associated with a reduced risk of CVD.

“We suggest eating mindfully, by paying attention to planning both what you eat and when you eat meals and snacks, to combat emotional eating. Many people find that emotions can trigger eating episodes when they are not hungry, which often leads to eating too many calories from foods that have low nutritional value,” wrote the authors.

Mice studies suggest that midnight or late-night snacking can reset your internal clock and can alter nutrient metabolism, which can lead to greater weight gain, insulin resistance and inflammation. But the AHA authors caution that large, long-term studies that track humans’ cardiovascular health are needed to confirm that results in the animal studies mirror effects in humans.

“This study clearly demonstrated that adults in the United States eat around the clock. Because feeding and fasting entrain clock genes, which regulate all aspects of metabolism, meal timing can have serious implications for the development of cardiovascular disease (CVD), type 2 diabetes mellitus, and obesity,” wrote the authors.

The main focus of the statement addressed how meal timing impacts CVD and other health conditions, but the authors stress that it is still crucial to eat a healthy diet, including fruits, veggies and whole grains, and limit salty or sugary foods to further prevent obesity, diabetes, high blood pressure and other conditions.

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