Understanding the link between frequency of eating and cardiometabolic health outcomes in Americans who "snack"

Authors: Hess, Julie

Submitted to: Journal of Dairy Science Communications
Publication Type: Review Article
Publication Acceptance Date: 8/13/2022
Publication Date: 10/8/2022
Citation: Hess, J.M. 2022. Understanding the link between frequency of eating and cardiometabolic health outcomes in Americans who "snack". Journal of Dairy Science Communications. 3(6):462-466. https://doi.org/10.3168/jdsc.2022-0289.
DOI: https://doi.org/10.3168/jdsc.2022-0289

Interpretive Summary: Americans eat 5 or more times per day, on average, but little is known about the association between eating frequency and health. Many factors, including food options, time of day, and eating occasion label can affect both the decision to eat and its impact on health. However, there is no consistent definition is used by researchers or consumers for “snacks," which affects the ability to ascertain whether eating occasions outside of meals is a healthful behavior or not. This review broadly covers the associations between eating frequency and health as well as the factors that influence people to eat more than three times per day and closes with an overview of the literature on dairy foods, specifically, as snacks. While few studies have been conducted on dairy foods (milk, cheese, yogurt) as snacks, the research that has been conducted indicates that solid and semi-solid dairy foods (yogurt, cheese) may be more filling than milk.

Technical Abstract: On average, Americans ages 2 years and older eat 5 or more times per day and consume nearly a quarter of their daily energy outside of breakfast, lunch, and dinner. Frequency of eating (FOE) has been identified by both the 2020 Dietary Guidelines for Americans Scientific Advisory Committee and the American Heart Association as an important area of study to improve the dietary patterns and overall health of the American public. However, the current evidence on FOE is conflicting; it does not indicate whether eating more frequently is a healthful behavior or not. Clinical and prospective studies have shown that FOE has an inverse relationship with some cardiometabolic health markers, including total cholesterol and low-density lipoprotein cholesterol concentrations, but the relationship between FOE and other health markers such as high-density lipoprotein cholesterol concentrations, blood pressure, obesity, and coronary heart disease incidence remain unclear. Several factors may affect the relationship between FOE and cardiometabolic health including the types of foods consumed, time of day, motivation to eat, cultural background, age, sex, and food security status. Another factor affecting both the relationship between FOE and health as well as the research on FOE and health is how eating occasions are labeled. Many definitions have been proposed and used in research to delineate between meals and snacks, but a consistent definition is not currently used for “snacks,” even in official dietary guidance. With the current limitations in the body of research, conclusions about the healthfulness of frequent eating cannot be drawn. In addition, conclusions cannot be drawn on the healthfulness of eating snacks (as an eating occasion) or more than three meals per day. More directed research is required to understand the relationships between the labels used for an eating occasion and cardiometabolic health outcomes as well as the health impacts of frequent food and beverage consumption and how and why they may vary among different population groups.