Should snacks be recommended in obesity treatment? a 1-year randomized clinical trial

Abstract

Objective: To study the effect to recommend no snacks vs three snacks per day on 1-year weight loss. The hypothesis was that it is easier to control energy intake and lose weight if snacks in between meals are omitted. Subjects/Method: In total 140 patients (36 men, 104 women), aged 18-60 years and body mass index430 kg/m 2 were randomized and 93 patients (27 men, 66 women) completed the study. A 1-year randomized intervention trial was conducted with two treatment arms with different eating frequencies; 3 meals/day (3M) or 3 meals and 3 snacks/day (3 þ 3M). The patients received regular and individualized counseling by dieticians. Information on eating patterns, dietary intake, weight and metabolic variables was collected at baseline and after 1 year. Results: Over 1 year the 3M group reported a decrease in the number of snacks whereas the 3 þ 3M group reported an increase (À1.1 vs þ 0.4 snacks/day, respectively, Po0.0001). Both groups decreased energy intake and E% (energy percent) fat and increased E% protein and fiber intake but there was no differences between the groups. Both groups lost weight, but there was no significant difference in weight loss after 1 year of treatment (3M vs 3 þ 3M ¼ À4.176.1 vs À5.979.4 kg; P ¼ 0.31). Changes in metabolic variables did not differ between the groups, except for high-density lipoprotein that increased in the 3M group but not in 3 þ 3M group (Po0.033 for group difference). Conclusion: Recommending snacks or not between meals does not influence 1-year weight loss.

Popcorn is more satiating than potato chips in normal-weight adults

“…This finding is supported by previous population-based research that shows popcorn consumption is not related to increased body mass index [19]. In addition, longitudinal [6] and weight loss interventions [33-36] indicate that snacking has a neutral or positive effect on energy intake or body mass index. For example, provision of up to three snacks daily as part a weight loss diet had a neutral effect on weight change [33-35].…”

“…In addition, longitudinal [6] and weight loss interventions [33-36] indicate that snacking has a neutral or positive effect on energy intake or body mass index. For example, provision of up to three snacks daily as part a weight loss diet had a neutral effect on weight change [33-35]. …”

Metabolic impacts of altering meal frequency and timing – Does when we eat matter?

“…However, increased meal frequency did not alter glucose response acutely [27,38] or after 2-weeks [13,69]. Fasting glucose was not different in obese men and women who consumed hypocaloric diets as either 3 or 6 meals per day for 12 months [52] or in individuals with type 2 diabetes after 4 weeks [70] (Table 2). One study reported that a hypocaloric diet consumed as 2 meals/d (breakfast and lunch) v. 6 meals/d produced greater weight loss, reduced hepatic lipid content, and improved insulin sensitivity in response to a GTT after 12 weeks in individuals with type 2 diabetes [54].…”

“…The rate of weight loss, fat loss and fat free mass loss was also not different in overweight women who were prescribed a 1000 kcal/d energy restricted diet as either 2 or 3e5 meals daily for 4 weeks [47]. There was also no difference in weight loss in obese men and women who were randomised to consume 3 meals, or 3 meals þ3 snacks for 12 months [52]. Similar findings have been reported in other studies that have been conducted for between 4 and 26 weeks in obese individuals [19,53,63], supporting the conclusion that there is little benefit to increasing meal frequency of hypocaloric diets, at least in terms of total weight loss.…”

“…Other studies show that increasing meal frequency does not alter blood lipids after 2e4 weeks [71] or 12 months [52]. To demonstrate the importance of considering meal frequency in the current obesogenic environment, Koopman et al prescribed a 40% hypercaloric diet, as either high-fat and high-sugar (HFHS), or high-sugar (HS), with the excess calories consumed either at meals (increased meal size) or between meals (increased meal frequency).…”