Eating Frequency and Weight Management

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NUTRI-BITES Webinar Series Eating Frequency and Weight Management March 3, 2016 Presenter: Richard D. Mattes, MPH, PhD, RD Distinguished Professor of Nutrition Science Purdue University Moderator: James M. Rippe, MD Leading cardiologist, Founder and Director, Rippe Lifestyle Institute Approved for 1 CPE (Level 2) by the Commission on Dietetic Registration, credentialing agency for the Academy of Nutrition and Dietetics.

ConAgra Foods Science Institute With a mission of: Promoting dietary and related choices affecting wellness by linking evidence-based understanding with practice

Webinar logistics CEUs a link to obtain your Continuing Education Credit certificate will be emailed and available on this webinar s page at www.conagrafoodsscienceinstitute.com within 2 days. A recording of today s webinar, slides as a PDF, and summary PowerPoint will be available to download within 2 days at: www.conagrafoodsscienceinstitute.com The presenter will answer questions at the end of this webinar. Please submit questions by using the Chat dialogue box on your computer screen.

Today s Faculty Richard D. Mattes, MPH, PhD, RD Distinguished Professor of Nutrition Science Department of Nutrition Science Purdue University Moderator: James M. Rippe, MD Leading cardiologist, Founder and Director, Rippe Lifestyle Institute

Eating Frequency and Weight Management NUTRI-BITES Webinar Series Learning Objectives Participants will understand the role of regulation as it pertains to energy balance Participants will understand the contribution of portion size to positive energy balance Participants will understand the contribution of eating frequency to positive energy balance Participants will be better prepared to develop effective weight management strategies for patients desiring to manage their body weight.

Ingestive Frequency vs Portion Size and the Risk of Obesity Richard D. Mattes, MPH, PhD, RD Purdue University West Lafayette, IN, USA Laboratory for Sensory and Ingestive Studies

Energy Intake is Determined by: Portion Size Ingestive Frequency

West DB, et al. Am J Physiol. 246:R776-R797, 1984

Swoboda & Temple Eating Behaviors 2013;14:149-156.

Malik et al., Nature Rev: Endocrinol 2012;doi:10.1038/nrendo. 2012.199

Young & Nestle Am J Publ Hlth 2002;92:246-249

The amount of lunch consumed by young adults as a function of portion size. Portion size is the percentage of the amount previously consumed when food was offered in a buffet and consumed ad libitum. Values are means ± SEM, n = 13. Means without a common letter differ, P < 0.05. Energy intakes [mean MJ and kc (kcal)] are given above each bar. Levitsky DA, Youn T. J Nutr. 134:2546-2549, 2004

Entrée Consumed by 63 (3-5 y/o) Children Energy Intake (g) Self-Served Plated Savage et al., 2012;96:36-43

Jeffrey et al., Intl J Behav Nutr Physical Act 2007;4:27

Young & Nestle, Am j Prev Med 2012;43:565-568

Popkin & Duffy AJCN 2010;91:1342-1347.

Popkin & Duffy AJCN 2010;91:1342-1347.

Piernas & Popkin J Nutr 2010;140:325-332

Kerver et al., JADA 2006;106:46-53.

Ingestive Frequency and BMI (Basis for Inconsistencies) True lack of causation Population characteristics (e.g., dieting status), snack definition (eating events) Planned vs unplanned snacks Insensitivity or bias of dietary data

Bellisle F et al., Br J Nutr 1997;77(Suuppl 1):S57- S70. Meal Pattern and Intake

CSFII Data (N = ~6500) McCrory et al., J Nutr 2011;141:148S-153S

Why has it proven to be difficult to address this problem?

Hagan & Niswender. Pediatr Blood Cancer 2012;58:149-153

Metabolic Cues and Feeding Glucostatic Theory (Mayer, Le Magnen, Russek) Aminostatic Theory (Mellinkoff) Lipostatic Theory (Kennedy, Mayer) Ischymetric Theory (Nicolaidis)

Metabolic Cues and Feeding Glucostatic Theory (Mayer, Le Magnen, Russek) Aminostatic Theory (Mellinkoff) Lipostatic Theory (Kennedy, Mayer) Ischymetric Theory (Nicolaidis) Commonality Salience of signal grew over post-prandial period and primarily influenced feeding initiation

Duca & Covasa Br J Nutr 2012; 108: 778-793

Woods SC. Cell Metab 2009;9:489-498.

Endocrine Cues and Feeding Gut peptides (e.g., CCK, GLP-1, GIP, PYY) promote satiation Commonality Salience of signal grew over ingestive event and primarily influenced portion size

Woods SC. Cell Metab 2009;9:489-498.

Snacks are Especially problematic because: Availability, Palatability, Social Acceptability

Ohkawara et al., Obesity 2013:21; 336-343.

Mattes & Considine. Physiol & Behav 2013; 120:173-181

Snacks are Especially problematic because: Availability, Palatability, Social Acceptability Weak energy compensation

Porrini et al., Physiol & Behav 1997; 62: 563-570

Snacks are Especially problematic because: Availability, Palatability, Social Acceptability Weak energy compensation Desensitization to appetitive signals

Fig. 1. Serum insulin responses to meal ingestion. The three trials, fasting control trial (FAST; S ), highfrequency meal trial (HIFREQMEAL; A ) and lowfrequency meal (LOFREQMEAL; --K- -), represent 8 h intervention periods where no meals, twelve meals or two meals were ingested, respectively. Meals within trials were equi-energetic and total energy consumption between HI- and LOFREQMEAL was identical Solomon et al., BJN 2008;100:810-819

Snacks are Especially problematic because: Availability, Palatability, Social Acceptability Weak energy compensation Desensitization to appetitive signals Low energy density/high energy density

Self-Reported Energy Intake NHANES 2003-2008 Kant et al., AJCN 2012;96:1369-1378

Self-Reported Energy Intake NHANES 2003-2008 Males Females Non-Beverage food (g) Non-Beverage food (g) Kant et al., 2012;96:1369-1378

What is the bigger problem? Portion size Ingestive Frequency

Change of Food (Kcal) Consumption (Males) 1977-1978 to 1994-1996 Meal 77-78 94-96 Change TOTAL 2080 2347 268 Breakfast 384 420 36 Lunch 517 567 50 Dinner 918 859-59 Snacks 261 501 241 Kcal/Eating Event 573 566-7 Eating Events/d 3.92 4.53 0.61 Cutler et al., J Econ Perspectives 2003;17:93-118.

Change of Food (Kcal) Consumption (Females) 1977-1978 to 1994-1996 Meal 77-78 94-96 Change TOTAL 1515 1658 143 Breakfast 286 312 26 Lunch 368 398 31 Dinner 676 602-74 Snacks 186 346 160 Kcal/Eating Event 422 408-14 Eating Events/d 3.86 4.44 0.58 Cutler et al., J Econ Perspectives 2003;17:93-118.

2.5 Mean # Daily Snacks ~2.25 2.25 Men Women 25 22.5 2 NHANES I 1971-1974 NHANES II 1976-1980 NHANES III 1988-1994 NHANES 1999-2002 NHANES 2003-2006 NHANES 2007-2010 % Energy from Snacks increased whereas that from Main Meals decreased. 85 82.5 % Energy from main meals (Men) 20 17.5 % Energy from snacks (Men) 80 % Energy from snacks (Women) 77.5 % Energy from main meals (Women) 15 NHANES I NHANES II 1971-1974 1976-1980 NHANES III 1988-1994 NHANES 1999-2002 NHANES 2003-2006 NHANES 2007-2010 Kant AK, Graubard BI. J Acad Nutr Diet. 2015 Jan;115(1):50-63. 75 NHANES I 1971-1974 NHANES II NHANES III NHANES NHANES NHANES 1976-19801988 - 1994 1999-2002 2003-20062007 - 2010

Duffey & Popkin PLoS Med 2011;8:e1001050

Duffey & Popkin PLoS Med 2011;8:e1001050

Summary Total energy intake is a function of Portion Size AND Eating Frequency Portion sizes and ingestive frequency have increased in concert with BMI There are biological and physiological influences on portion size and ingestive frequency In Humans, the evidence more strongly implicates increases in ingestive frequency in the promotion of positive energy balance

Questions?

Eating Frequency and Weight Management NUTRI-BITES Webinar Series Based on this webinar the participant should be able to: Understand the role of regulation as it pertains to energy balance Understand the contribution of portion size to positive energy balance Understand the contribution of eating frequency to positive energy balance Develop effective weight management strategies for patients desiring to manage their body weight.

ConAgra Foods Science Institute Nutri-Bites Webinar details A link to obtain your Continuing Education Credit certificate will be emailed within 2 days Today s webinar will be available to download within 2 days at: www.conagrafoodsscienceinstitute.com For CPE information: acontinelli@rippelifestyle.com Recent CEU webinars archived at the ConAgra Foods Science Institute website: Vitamin D and Calcium: New Research-New Recommendations Towards a Sustainable Food Supply: Myths and Realities Setting the Record Straight on Cholesterol, Saturated Fat, and Heart Disease Risk Nutrition Support for the Bariatric Patient Critical Evaluation of Nutrition Research Functional Foods: Phytochemicals Hidden Nutrition Gems

Next ConAgra Foods Science Institute Nutri-Bites Webinar Will Be Announced Soon. Please check our website for more details. www.conagrafoodsscienceinstitute.com

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