Endpiece: A chameleon

ObjectivesTo examine the relation between self reported eating frequency and serum lipid concentrations in a free living population.Design Cross sectional population based study.Setting Norfolk, England.Participants 14 666 men and women aged 45-75 years from the Norfolk cohort of the European prospective investigation into cancer (EPIC-Norfolk).Results Mean concentrations of total cholesterol and low density lipoprotein cholesterol decreased in a continuous relation with increasing daily frequency of eating in men and women. No consistent relation was observed for high density lipoprotein cholesterol, body mass index, waist to hip ratio, or blood pressure. Mean cholesterol concentrations differed by about 0.25 mmol/l between people eating more than six times a day and those eating once or twice daily; this difference was reduced to 0.15 mmol/l after adjustment for possible confounding variables, including age, obesity, cigarette smoking, physical activity, and intake of energy and nutrients (alcohol, fat, fatty acids, protein, and carbohydrate).Conclusions Concentrations of total cholesterol and low density lipoprotein cholesterol are negatively and consistently associated with frequency of eating in a general population. The effects of eating frequency on lipid concentrations induced in short term trials in animals and human volunteers under controlled laboratory conditions can be observed in a free living general population. We need to consider not just what we eat but how often we eat.

What is already known on this topic

Studies in animals and small human trials indicate that eating frequency is inversely related to serum lipid concentrationsFew studies have examined this in a free living population under no dietary restrictions

What this study adds

In a free living population increased eating frequency was negatively and significantly associated with concentrations of total cholesterol and low density lipoprotein cholesterolThis association was still present after adjustment for body mass index, physical activity, cigarette smoking, and dietary intakeMean age adjusted cholesterol concentrations differed by 0.25 mmol/l between people eating more than six times a day and those eating less than twice daily