Meal Frequency and Meal Patterning Part 1 – Book Excerpt

As editing grinds on (I’m past the 2/3rds mark so be patient) on the woman’s book, and since I can’t think of anything to write this week, I’m going to run another excerpt.  Since it’s long I’ll run half of it today and half of it next week; that way I don’t have to write anything for two weeks.  This is the first half of the chapter on meal frequency and patterning.

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Chapter 13: Meal Frequency and Meal Patterning

In the last chapter, I looked in a great deal of detail at concepts related to setting up what I consider an optimal diet. This included a look at general dieting concepts along with information about setting protein, fat, carbohydrate and sodium/potassium intake. I also looked at fluid intake and artificial sweeteners.

Having set up a diet, there are additional issues that need to be addressed such as meal frequency and overall meal patterning (on a given day) and calorie distribution (over the course of the week). I’ll look at each in some detail including some relatively “new” approaches that may be superior under some conditions. Finally I’ll end this chapter by looking at a question that most may have never considered.

Meal Frequency: Myths and Misconceptions

The first topic I want to discuss in this chapter is meal frequency, how many times someone eats in a day. This is yet another area where there is a number of myths and misconceptions and where many old ideas about what must be done for health or fat loss turn out to be generally incorrect. The general idea is that a high meal frequency (typically 6 times per day depending on where you look) has enormous metabolic and other benefits and that you must eat this frequently for optimal health and fat loss.

The idea is repeated endlessly and entire books have been written about the idea of eating every few hours and obsessed individuals will often put themselves into a truly pathological state to adhere to this supposed perfect meal frequency or spacing. You hear of people sneaking away from their workstation to eat in the bathroom or skipping social events or going out for the same reason.

One of the most common claims is that eating more frequently stokes the metabolism, based on the thermic effect of food and slight increase in metabolic rate that does occur with eating. But remember that TEF is related to the amount of food eaten during a meal (and estimated at 10% of total calories on average).

If someone is eating 1800 calories per day, their TEF will be 180 calories. If they eat six three-hundred calorie meals, the TEF per meal will be 30 calories, or 180 total. If they eat 3 six-hundred calorie meals, the TEF per meal will be 60 calories, or 180 total. Put differently, for the same total amount of calories, there is no impact of meal frequency on the total TEF or energy expenditure (1).

Another common claim is that skipping a meal, or even going too long between meals, will put the body in a starvation mode where it hoards calories and limits fat loss (or even slows metabolic rate). This belief seems to be especially prevalent for breakfast where claims that skipping breakfast will induce starvation mode or eating breakfast will “stoke the metabolism” all day. The latter is just another misunderstanding of TEF and I’ll address breakfast in more detail below.

The idea that skipping a meal causes a drop in energy expenditure or “starvation mode” came out of early animal research on mice and rats and certainly it’s true that even short periods without food do cause this to occur. But it’s critical to realize that small animals have a very short lifespan, mice live about two years and rats perhaps three times as long. These animals also don’t carry much body fat so even a slight caloric deficit can be very dangerous indeed (in some very small animals, missing a single meal can cause death).

What this means is that a single meal or day’s eating for these animals is a much more significant portion of their life than it is for a human. A meal for a mouse might be the equivalent of a day or more’s eating for a human; a day without food is probably equal to 4-7 days. Human metabolic rate doesn’t even begin to slow with 3-4 days of total starvation and some studies find that it goes up a little bit. A single meal means nothing and even a single day without food won’t noticeably affect anything (recall that it takes the brain 3-4 days to even notice the drop in leptin).

It’s almost universally stated that eating more frequently either increases fat loss or spares the loss of lean body mass (LBM) while dieting but this really only holds true for extreme differences in meal frequency and even then only when dietary protein intake isn’t sufficient. When protein intake is high enough, meal frequency becomes more or less irrelevant. Anyone following the guidelines from the last chapter will be eating sufficient protein.

And research clearly shows that any meal frequency between 3-4 times per day shows no difference in either fat loss or LBM maintenance (2). While I’ll talk more specifics in the next section, individuals should pick the meal frequency that best suits their personal needs and preferences. Any idea that there is a required or optimal meal frequency is simply incorrect. And as I’ll discuss below, there may actually be reasons for some dieters, and especially lighter female dieters to use a lower meal frequency than the normally recommended six per day.

There are some other claimed benefits to a higher meal frequency including keeping blood sugar stable or keeping people fuller. The first has usually been tested with completely unrealistic meal frequencies, often comparing 3 larger meals to 17 tiny meals. This has no relevance on normal eating patterns. Even the issue of hunger is debatable with one recent study finding that eating more frequently actually made people hungrier (3). Eating more frequently also didn’t increase fat burning.

Meal Frequency: Practical Aspects

Hopefully it’s clear that there is no magic to a high meal frequency for either general health, fullness or successful fat loss. But one idea that is rarely considered is that a lower meal frequency might actually be superior at least in certain situations. A primary reason for this is recent work suggesting that meal size it an independent factor in determining whether it is filling or not; that is, this works outside of the hormonal factors I’ve discussed. Effectively, meals that are too small may not be as filling as meals that are larger; the mechanism behind this is currently unknown.

But this raises a critically important issue for smaller females, and especially when they are on reduced calories and dieting. With fewer calories to work with, a high meal frequency ends up making each meal almost insignificant in size. So consider our sample female dieter on 2000 calories/day. At 6 meals per day, each meal is just over 300 calories. At 4 meals per day, each meal is now 500 calories.

While both may be workable, eventually her caloric intake may come down and many females find themselves on 1400-1600 calories per day at some point in the diet. At this point, 6 meals per day makes each meal between 233-266 calories per day. A female at 1200 calories/day would be eating 200 calories per meal. And this becomes hardly a meal and certainly not a satisfying or filling meal almost no matter what food choices are made.

If these situations were moved to 3-4 meals per day, or 3 meals and a snack, that would raise the calories per meal to 300-400 or so which at least allows for a decent sized meal and amount of food. This allows for each meal to contain some amount of protein, vegetables, some fat and a small amount of other digestible carbohydrate to actually make the meal filling.

In contrast, switching to 3-4 meals, or 3 meals and a snack or what have you makes the meals 350-400 calories which is a meaningful amount of food. Even on 1200 calories, 3 meals and a snack mean each meal can be larger relatively speaking. This allows for the meal to contain adequate protein, some type of carbohydrate, vegetables and enough dietary fat to actually keep the meal in the stomach and maintain fullness.

Once again, this is an issue that larger males with a higher energy expenditure may simply not run into. Dieting on 2000 plus calories makes it far easier to maintain a higher meal frequency while keeping each meal much more satisfying. Splitting their meals into 6 has much less of an impact on meal size than it does for generally smaller females.

I should mention that one place where higher meal frequencies is often superior or even required is for highly active athletes who have a very high energy expenditure. This usually means highly trained athletes doing a large volume of training. To avoid making each meal uncomfortably large, a higher meal frequency can be superior here. Even while dieting, since they are typically eating more, very active athletes may be able to maintain a higher meal frequency (if desired).

Ultimately, given that there is no inherent benefit to a higher meal frequency in terms of metabolism, fat loss or much of anything else, readers should pick the meal frequency which works best for them in terms of their lifestyle, hunger, energy levels, mood, etc.

Realistically, smaller females are likely to do better with fewer but larger meals unless their energy expenditure is very high. Larger females, or highly trained athletes, may find a higher meal frequency to be superior. So long as at least three meals per day with adequate protein are being consumed, it really doesn’t matter beyond this.

Which brings me to the next topic, that of meal patterning, which actually interacts with the meal frequency discussion from above.

Meal Patterning

Meal patterning refers to how the day’s calories or meals are distributed throughout the day and clearly this will interact to some degree with how many meals are being eaten. This topic can get fairly complicated and an enormous number of patterns have been successful for one person or another; that alone should indicate that there are no absolutes here.

Certainly some approaches to meal patterning may be relatively better or worse for a given situation but readers must really get away from the idea that some specific pattern must be followed. I’m going to look a at a number of commonly used patterns and will be assuming a daily intake of 2000 calories across four meals per day. All that will differ is in the way that they are distributed.

Even Distribution

Probably the most common meal pattern is a simple even distribution with the day’s calories spread relatively evenly across the day. So a four meal even distribution might mean eating at 8am, 12:30-1pm, 5pm and 8pm and generally speaking every meal would have roughly the same distribution of protein, carbohydrate and fats (within a similar range in any case).

This types of distribution convenient for many since it fits the normal work day schedule (the 5pm meal may be a problem) and can even accommodate an evening workout in between the third and fourth meal. While convenient, there are actually some very good reasons for most people to use some type of uneven distribution of their daily calories.

Uneven Distribution

By definition, any other meal or calorie pattern that isn’t an even distribution if an uneven distribution. Here things can get very complex as both how meals and the day’s calories are distributed across a day can vary. So potentially any given meal could have different amounts of protein, carbs, fats, etc. While the specific amounts can vary, I generally think that every meal (or perhaps eating occasion) should contain some amount of each nutrient although this may not always be possible.

A piece of fruit isn’t really an appropriate meal for the most part and neither is any other single nutrient with the possible exception of protein. Except around a workout (see below), try to get some of each of the major macronutrients at each meal (even a meal of protein, vegetables and some dietary fat technically

In the general public, probably the most common uneven distribution would be three primary meals at breakfast, lunch and dinner with one or two snacks in-between. So for a fairly typical 9-5 type of job, that might be breakfast at 7:30am, a snack at 10:30am, lunch at 1pm, a snack at 4pm and dinner at 7-8pm or something in that range. The best way to set up this type of distribution would be to subtract out the snacks and then determine the size of the other three meals.

So our sample dieter with 2000 calories daily might factor in two 200 calorie snacks, leaving 1600 calories across the other three meals. That would leave 530 calories per meal which should be nice and filling. Since the smaller snacks are coming at a little bit higher frequency, any issue with fullness should be mostly avoided. I still recommend each snack contain some amount of protein, carbohydrates, fiber and fat if at all possible.

This is a place where protein bars or pre-packaged liquid meal replacements may be especially useful although they are not always the most filling. A single serving of low- or medium-fat yogurt (ideally with some type of fiber powder thrown into it) would contain protein, carbohydrates and some fat along dairy calcium and there many other options that can be worked out here.

Larger Evening Meals

One type of uneven distribution that may be very worth considering is one when relatively larger meals are eaten in the evening. Yes, there is still a myth floating around that larger meals at this time magically turn to fat but that isn’t the case on any level. And this type of approach may have a number of benefits, once again especially when dieting. A majority of people work during the day and since that keeps them busy, they often aren’t that hungry. Or, perhaps more accurately, are distracted from eating by other things.

As well, nighttime when most people are home, bored, not busy can be a problematic time from an eating standpoint and nighttime hunger can be a real diet breaking issue. Shifting more of the calories to the evening during this time can have a number of benefits. It allows for a larger meal to be eaten at dinner which may be helpful for folks with families so they don’t have to eat a tiny diet meal while the rest of the family is eating normally.

As well, larger meals and/or relatively more carbohydrates at night-time can help with sleep issues. Not only aren’t dieters not trying to go to sleep hungry, the carbohydrates tend to affect brain chemistry (primarily serotonin which helps with sleep). Some have even taken this to the extreme where predominantly protein, vegetables and some fat are eaten during most of the day while most carbohydrates are eaten in the evening. Women, due to their tendency to have blood sugar issues (especially during the luteal phase) may want to put in some fruit earlier in the day.

For older individuals, there may be even more potential benefits. There is evidence that, with age, skeletal muscle becomes relatively more resistant to the effects of dietary protein on skeletal muscle metabolism and this contributes to the age-related loss of muscle (sarcopenia) that can occur.

A strategy called protein-pulse feeding, with as much as 70% of the day’s protein intake at one of the meal’s of the day (the other 30% is spread out) has been shown to have benefits here (4) and this might be worth considering as women approach menopause. I doubt it has to be done at this extreme but putting proportionally more protein in the evening meal may be worth considering. Note that this has not been shown to have benefits in young people with a more evenly spread out protein intake is superior.

For women who train in the evenings, there are other benefits to putting relatively more calories in the evening which brings me to the next topic.

Around Workout Nutrition

Although the meal patterns described above are appropriate for the general public, those involved in exercise training and especially weight training have another issue to consider which are any calories and nutrients consumed around a workout. I mentioned this briefly when I talked about athletes increasing their caloric intake on training days by putting extra calories after their workout but want to go into more detail.

I should mention that while beneficial, this is not as important as it was once thought. The idea that there is some magic post-workout “window” for eating that closes after some period of time turns out not to be completely accurate (5). At the same time a considerable amount of research shows that post-workout protein helps to improve adaptations; it will rarely hurt to consume at least some nutrients following resistance training.

However, under certain conditions, it’s clear that post-workout nutrition may be relatively more important. One of these times is during fat loss dieting. Part of the reason that lean body mass (LBM) is lost is due to changes in hormones which negatively impact on skeletal muscle metabolism. Protein synthesis (building muscle) decreases and protein breakdown increase. And the combination of proper resistance training with post-workout protein effectively reverses this (6).

Perhaps, surprisingly, this is a place where there are no major gender differences in terms of what types of nutrients should be consumed for recovery; the only difference is in the amounts due to differences in body size (7). Smaller females in heavy training will simply need proportionally less after a workout to stimulate recovery than larger females or generally larger males.I mentioned above and throughout this book that at menopause, women start to suffer from sarcopenia and there is currently a large degree of interest in how to reverse this. And one factor is the combination of proper resistance training along with dietary protein, both intakes above normal and some consumed right after training (8).

For all of these reasons, consuming some nutrients and calories after training would be ideal for those involved in resistance training. For the most part, unless the duration or intensity of an endurance/aerobic type of workout is very high (as would be seen in performance athletes), this type of post-workout nutrition isn’t required.

At the very least protein, and ideally protein with some carbohydrate should be consumed after training; carbohydrates by themselves are not optimal. This combination has an additional benefit for smaller women; adding protein to carbohydrates improves the storage of carbohydrate in muscle without having to eat as many carbohydrates. Calories can be kept lower while still obtaining the same recovery benefits (9). Athletes who are not restricting calories or who have a very high energy expenditure can consume more carbohydrates here.

It’s been debated for quite some time what optimal post-workout nutrition might be. There is some indication that whey protein (10), a type of dairy protein that is very quickly digesting, may be the best post-workout protein. This may doubly true for older individuals as the fast digestion speed may overcome the resistance that skeletal muscle can develop. Women approaching menopause should consider supplementing with whey protein after resistance training; this will also help to bump up total protein intake.

A typical amount of post-workout nutrition for women might be in the realm of 100-200 calories with 20-25 grams of protein (80-100 calories) and another 20-25 grams of carbohydrate (80-100 calories) if they are consumed. Many find that they are not very hungry after an intense workout and liquids are often superior here. Various commercial products are available with different combinations of protein and carbohydrates and I’ll talk about protein powders briefly in Chapter 15.

But there may be a much more convenient form of post-workout nutrition which is nothing but good old fashioned milk. Although only a portion of the protein in milk comes from whey, it’s looking like it might represent an optimal post-workout drink, improving recovery and helping with rehydration (11,12).

One eight ounce glass of milk will contain 80-120 calories, 8 grams of protein, 12 grams of carbohydrates and variable amounts of fat and perhaps double that amount of calories would be optimal. This would also provide dairy calcium and Vitamin D. If you don’t want to drink that much fluid at once, 8 oz of milk with one half scoop of whey protein and a half piece of fruit would provide a nearly ideal post-workout meal with ~20 grams of protein, 25 grams of carbohydrate with a little bit of fructose.’

And, getting back to the topic of meal patterning, the above is importance since the inclusion of at least some nutrients after a workout means that the overall patterning of the day will be changed at least somewhat. The first thing that needs to happen is that any post-workout calories be subtracted from the day’s total.

So let’s say that our 2000 calorie/day dieter is consuming 200 calories (25 grams protein and 25 grams carbs) after training leaving 1800 calories for the rest of the day. Across four other meals, that allows each to be 450 calories if they are distributed evenly although they could be distributed even more unevenly as desired.

As I mentioned above, assuming an evening workout, putting more calories in that time period, some immediately after the workout and a larger dinner meal while consuming relatively less calories earlier in the day may provide not only recovery benefits but also help with sleep, etc. while dieting. Note that many athletes perform more than one workout per day and calories will probably have to be spread out more.

The Issue of Breakfast

Having looked at post-workout nutrition and suggesting that putting relatively more calories in the evening may have a number of benefits, I want to address another fairly pervasive idea which has to do with the relatively importance of breakfast. I mentioned in the section on metabolic rate that the old idea that breakfast stokes the metabolism or that skipping breakfast puts the body into a starvation mode are both nonsensical as the body doesn’t adapt on a meal-to-meal basis like this.

But there is also quite a bit of observational research that folks who skip breakfast are fatter and this has been interpreted as saying that skipping meals makes you fat. But there is a problem here with cause and effect. Just as with the use of diet products, many people start to skip meals after they have gained weight. But it wasn’t the meal skipping that caused the problem.

Certainly for some people skipping meals can cause them to be hungrier later in the day; if this causes them to eat more than they otherwise would during the day. But research typically shows the opposite, that even if people eat slightly more later in the day, their total daily calorie intake goes down when they skip breakfast (13). Even if someone eats 200 calories more later in the day, if the skipped breakfast would have been 500 calories, they have still eaten 300 calories less that day.

And while it is often found that those who eat breakfast perform or think better, and this is especially seen in children and school performance, there is an adaptation issue. After a few days, people get used to not eating breakfast. When you feed someone who normally skips breakfast a meal, they perform worse and when you make a normal breakfast eater skip breakfast, they also perform worse (14).

For female dieters, especially smaller females, with fewer calories to play with, often clustering their calories later in the day can give them even larger meals. People who work a day job are often busy enough to not get hungry and even caffeine or one of the stimulants I’ll describe in the supplement chapter usually make appetite go right away. As I mentioned above, moving more calories to the evening time when hunger is worse goes hand in hand with this. Skipping breakfast entirely saves more calories for later in the day; when dieting for fat loss this can be enormously beneficial when there isn’t that much food to be eaten.

References for Chapter 13: Meal Patterning

1. Bellisle F et. al. Meal frequency and energy balance. Br J Nutr. (1997) 77 (Suppl 1):S57-70.
2. Schoenfeld BJ et. al.Effects of meal frequency on weight loss and body composition: a meta-analysis Nutrition Reviews (2015) Vol. 73(2):69–82
3. Ohkawara K Effects of increased meal frequency on fat oxidation and perceived hunger. Obesity (Silver Spring). 2013 Feb;21(2):336-43
4. Arnal MA et. al.Protein pulse feeding improves protein retention in elderly women. Am J Clin Nutr. 1999 Jun;69(6):1202-8.
5. Aragon A. and BJ Schoenfeld. Nutrient timing revisited: is there a post-exercise anabolic window? J Int Soc Sports Nutr. (2013) 10: 5.
6. Areta JL Reduced resting skeletal muscle protein synthesis is rescued by resistance exercise and protein ingestion following short-term energy deficit. Am J Physiol Endocrinol Metab. (2014) 306(8):E989-97.
7. Hausswirth C1, Le Meur Y. Physiological and nutritional aspects of post-exercise recovery: specific recommendations for female athletes. Sports Med. 2011 Oct 1;41(10):861-82.
8. Denison, HJ et. al. Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older peopleClin Interv Aging. 2015; 10: 859–
9. Betts JA1, Williams C.Short-term recovery from prolonged exercise: exploring the potential for protein ingestion to accentuate the benefits of carbohydrate supplements. Sports Med. 2010 Nov 1;40(11):941-59.
10. Devries MC1, Phillips SM. Supplemental protein in support of muscle mass and health: advantage whey. J Food Sci. 2015 Mar;80 Suppl 1:A8-A15.
11. Saunders MJ. Carbohydrate-protein intake and recovery from endurance exercise: is chocolate milk the answer? Curr Sports Med Rep. 2011 Jul;10(4):203-10.
12. Desbrow B et. al. Comparing the rehydration potential of different milk-based drinks to a carbohydrate-electrolyte beverage. Appl Physiol Nutr Metab. 2014 Dec;39(12):1366-72.
13. Levitsky DA1, Pacanowski CR.Effect of skipping breakfast on subsequent energy intake. Physiol Behav. 2013 Jul 2;119:9-16.
14. Thomas EA et. al.Usual breakfast eating habits affect response to breakfast skipping in overweight women. Obesity (Silver Spring). 2015 Apr;23(4):750-9.

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And that’s where I’ll wrap up Part 1 of the book excerpt on meal patterning.  I’ll pick up next week with Intermittent Fasting (IF’ing) and some of it’s interpretations and then summarize all of the above.  There will be charts.

Read Meal Frequency and Meal Patterning Part 2

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