Dr. Tim Says....

Three Meals a Day

Last week I discussed the structure of dinner and what a good healthy and balanced evening meal should look like. I have felt for a long time that eating sensible regular meals and snacks is the key to being healthy and maintaining a healthy weight. In listening to my overweight and obese patients I often hear them say, “Well, I don’t eat during the day. I only eat dinner.” Sometimes they will talk about eating late in the day.

While this is only anecdote, hearing it over and over has made me think that there’s something to this. Yet there’s not a lot of definitive research to prove that skipping meals during the day and eating only dinner contributes to weight gain. We do have some indirect information from studies showing that eating breakfast makes a difference in maintaining a healthy weight. There’s less info about lunch, however. We do have a lot of research on snacking. Everything from time of snacks, type of snack, how much is consumed and on and on.

There’s also a lot of research on the volume of food and calorie density that helps us to understand how satisfying various meals and snacks are throughout the day. There’s a great addition to our knowledge with a group of researchers in Sweden reporting on whether meal patterns might have an effect on obesity.

They looked at just over 3,600 men and women with about 15% of them being obese (BMI >30). Interestingly, the number of calories consumed each day was similar between the obese and non-obese participants. The obese subjects were less likely to consume alcohol and had a higher percentage of their calories from sugar. They also ate more protein and less fiber than those of normal weight.

The big difference was that the obese folks skipped breakfast and lunch. This has been observed before in smaller studies - often enough to have acquired the name “night eating syndrome.” This study also showed that obese folks reported eating larger meals, with increased portion sizes across the board. This does make some sense given that they ate fewer meals but the same number of calories.

What to make of this research? I believe that this is a big step forward in knowing whether meal patterns make a difference in weight control. It certainly appears that it does make a difference.

We are now coming to understand how best to help people best eat healthy, lose weight and maintain a healthy weight. Information such as this along with the work of so many great researchers on everything from Mediterranean diet to calorie density to snacking that help us understand exactly what works best.

Eat well, eat healthy, enjoy life!

Timothy S. Harlan, M.D.
Dr. Gourmet
April 20, 2009
Last updated: 04/20/09