Experts debate how often we should eat for weight loss

By Elaine Magee, MPH, RD, LD
WebMD Weight Loss Clinic - Feature

To eat three meals a day or to eat six small meals a day: that is the question. If you have heard about or read Jorge Cruise's new book, The 3-Hour Diet, you would bet the answer is the latter. But many nutrition researchers out there say, "not so fast!"

Cruise's plan boasts a three-point approach: eat breakfast within one hour of rising, eat every three hours, and stop eating three hours before bedtime. He says this ritualized way of eating increases BMR (baseline metabolic rate), increases energy levels, and decreases appetite, among other things. While many nutrition experts agree that when it comes to weight loss irregular eating patterns and skipped meals can mean trouble for most of us, there isn't anything close to a consensus on whether we are metabolically better off eating three regular meals a day or spreading that out into five or six smaller meals.

Bonnie Liebman, nutrition director of CSPI (Center for Science in the Public Interest) would like to see the studies Cruise used to formulate his 3 Hour Diet. "If there are any good studies proving his point, they certainly aren't well established," says Liebman.

And ADA spokeswoman Noralyn Mills, RD, believes if we feed the body at regular intervals we send a signal to the body that it doesn't have to store calories and when we skip meals, we affect the metabolism negatively. "But this can be accomplished with three regular meals a day for many of us," she notes.

Gary Schwartz, a researcher with the Albert Einstein College of Medicine, answered, "There's no strong data supporting either [three meals a day or six meals a day] as being more effective" for losing weight or maintaining lost weight. "Clearly there is an emphasis on reducing caloric intake overall, whether it be by decreasing meal size and/or decreasing meal frequency."

In a recent American Journal of Clinical Nutrition editorial, a team of nutrition researchers concluded that whether you are practicing the "three" or "six" meal daily dietary pattern, weight loss ultimately comes down to "how much energy (or calories) is consumed as opposed to how often or how regularly one eats."

So given the tried-and-true equation for weight maintenance: Calories "in" = Calories "out," what this really boils down to is whether eating five or six small meals a day truly helps us to:

Burn more total calories at the end of the day
Eat fewer total calories at the end of the day

As far as increasing the calories we burn, "The only thing that has been consistently shown to increase BMR is exercise," says Vicki Sullivan, PhD, RD, LD, national lecturer and president of Balance, LLC. Sullivan agrees that eating every three hours would certainly help some people control appetite and feel more energized, but she also believes that everyone is different. "I have clients who find that they gain weight when they eat more frequently, or some simply cannot eat every three hours due to job constraints."

Karen Collins, MS, RD, CDN, with the American Institute for Cancer Research, noted that in a recent study, the baseline metabolic rate (how fast the body burns calories) was unaffected by differences in meal timing. "Other studies also show that eating frequency has no effect on a person's overall metabolic rate," says Collins.

The answer to No. 2, it seems, can only be found within each individual. The truth is, the more times a day you sit down to eat a meal or snack, the more opportunities you have to overeat; this can be a serious problem for some people. If you are someone who has a difficult time eating a small amount at a meal or snack (you have a hard time stopping once you get started), then it's quite possible that, for you, eating five or six times a day isn't the best way to go.

The trick is eating when you are truly hungry but not so ravenous that you are at risk of overeating or eating out of control. To me, true hunger is when your stomach feels definitely empty; but once you feel this, don't go more than an hour without eating or you will move from truly hungry to ragingly ravenous. According to the ADA, eating every time you feel "slightly" hungry can result in overeating. Their remedy for this is to ask yourself these questions before a meal if you aren't sure:

Am I hungry? (If unsure, wait 20 minutes and ask yourself again)
When was the last time I ate? (If it's less than three hours, it may not be real hunger)
Could a small snack tide me over until the next meal? (Have ready-to-eat fruits or vegetables on hand for this)

And if you have a difficult time sticking to healthier meal choices -- perhaps you have a tendency to choose "junk" foods in between the regular meals -- then eating five or six times a day may end up being a diet disaster. Some of us are simply more in tune with our body's natural cues to eat when we are truly hungry and to stop when we are comfortable (not full). When we follow this mealtime mantra, some of us may very well end up eating five or six small meals, but for others, it may end up being three or four. What if you can't recognize when you are truly hungry? The American Dietetic Association suggests making a schedule and eating small meals every three or four hours until you learn what hunger feels like. If you overeat at one of the meals, get back on track at the next one.

Breakfast Basics

No matter whether you end up eating three or six meals a day, breakfast is still the first of those meals. "Getting people to eat breakfast at all would be a great improvement and is a long-standing, well-documented way to help with weight loss and weight management," says Sullivan. Most of us wake up relatively hungry, especially if we ate light the night before. But some of us need more time to wake up our gastrointestinal tract just a bit. Let your hunger be your guide.

"It's common sense: If you wake up hungry, eat. I'm not sure it's important to force yourself to eat," says Liebman. "People think that any breakfast is better than no breakfast, and that's just not true for adults."

The two proposed benefits of breakfast are:

It increases your metabolism
People who skip breakfast tend to eat more total calories by day's end.

According to Lisa Most, RD, clinical dietitian at Greater Baltimore Medical Center, your metabolism does increase if you eat breakfast. As far as eating more later in the day if you skip the all-important breakfast, have you found this to be true for you? If you skip breakfast, are you more likely to pass the point of no return with your hunger later that morning, and does it encourage you to overeat when you do finally get the opportunity to eat?

British scientists did find, in a recent study, that women who skipped breakfast ate more calories during the rest of the day and also had higher fasting levels of LDL (bad cholesterol) and total cholesterol compared with the women in the breakfast-eating group. The researchers noted that skipping breakfast could lead to weight gain if the higher calorie intake was sustained.

The bottom line to breakfast is to consider breakfast as an ideal opportunity to fit in some of those smart foods we should get several servings of every day, like fruit, whole grains, and low-fat dairy. You can even get some veggies in depending on the breakfast dish!

Published Aug. 12, 2005.

SOURCES: Bonnie Liebman, nutrition director, Center for Science in the Public Interest. Noralyn Mills, RD, spokeswoman, American Dietetic Association. Gary Schwartz, Albert Einstein College of Medicine. Parks, E.J. American Journal of Clinical Nutrition, January 2005; vol 81: pp 3-4. Vicki Sullivan, PhD, RD, LD. Karen Collins, MS, RD, CDN. Farshchi, H.R. American Journal of Clinical Nutrition, February 2005; vol 81: pp 388-396.

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