IMPACT OF MEAL FREQUENCY ON APPETITE AND BLOOD MARKERS OF HEALTH IN OBESE WOMEN UTILIZING AN EQUI-HYPOCALORIC DIET DURING A BEHAVIORAL WEIGHT LOSS INTERVENTION
Background: Obesity prevalence is a global pandemic and a public health concern. Beneficial weight loss strategies are needed for obesity management. Increased daily meal frequency (MF) is often associated with improvements in blood-markers of health and appetite control during weight loss; however, this has not been confirmed using portion-controlled meal products to reduce underreporting error. Objective: The purpose of this study was to determine if increased MF can be a beneficial treatment strategy for weight loss in obese women by determining the changes of total ghrelin, blood glucose, insulin, lipid concentrations, and sensations of hunger and satiety due to an equi-hypocaloric diet intervention during a two meals per day sequence (2 MF) versus a three meals and three snacks per day sequence (6 MF) using portion-controlled products. Design: Eleven (N = 11) obese female subjects (BMI 39.1 ± 7.6 kg/m2) ages 52 ± 7 years completed a six-week study using a randomized cross-over design. Subjects were randomized to either the 2 MF or 6 MF treatment condition for two-weeks, had a two-week washout of three meals and one snack per day, and then alternated treatment conditions. Results: All subjects lost a similar percentage of body weight 6.6 ± 1.6% (6.2 ± 1.9 kg) which was not significantly different (P > 0.05) between the 2 MF and 6 MF conditions. Percent change analysis in fat-free mass (FFM) showed significant differences between conditions. Results showed 3.3 ± 2.6% decrease in FFM following the 2 MF condition, while following the 6 MF condition there was an average increase of 1.2 ± 1.7% in FFM (P ≤ 0.05). There were no significant differences between conditions for fasting and area-under-the-curve (AUC) values of glucose, insulin, and total-ghrelin. Fasting high-density lipoprotein cholesterol (HDL-C) concentrations were significantly lower than baseline during the 6 MF condition (49 ± 10 vs. 53 ± 12 mg/dL, respectively) where the percent change in HDL-C during the 2 MF condition was significantly higher than in the 6 MF condition (1.3 ± 12.2% vs. 0.12 ± 10.3%). There was a significant decrease (P = 0.006) in glucose AUC from baseline to the six-week follow up. There were no significant differences found for fasting triglycerides, total cholesterol, or low-density lipoprotein cholesterol (LDL-C) between conditions. There was a significant difference from baseline to the six-week follow-up respectively for glucose AUC (13,122 ± 1,726 vs 12,296 ± 1,870 mg/dL∙120 min) and hunger ratings (1,894 ± 887 vs 3,131 ± 1,563 mm∙120 min, P < 0.05). Conclusions For our sample increasing MF from two to six occasions per day did not promote greater improvements in blood-markers of health, appetite control, or total-ghrelin levels during a portion-controlled strict reduced-calorie diet intervention. Additionally, reduced MF may attenuate losses in HDL-C levels while increased MF may reduce losses in FFM during weight loss.
meal frequency, obese, eating frequency, ghrelin, hypocaloric-diet, weight loss, behavior
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