Conclusion Statement
Insufficient evidence is available to determine the relationship between the frequency of eating and growth, size, body composition, and risk of overweight and obesity. (Grade: Grade not assignable)
Plain Language Summary
What is the question?
- The question is: What is the relationship between the frequency of eating and growth, size, body composition, and risk of overweight and obesity?
What is the answer to the question?
- Insufficient evidence is available to determine the relationship between the frequency of eating and growth, size, body composition, and risk of overweight and obesity.
Why was this question asked?
- This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.
How was this question answered?
- The 2020 Dietary Guidelines Advisory Committee, Frequency of Eating Subcommittee conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.
- Frequency of eating was defined as the number of daily eating occasions.
What is the population of interest?
- The population of interest was generally healthy children through older adults (ages 2 and older).
What evidence was found?
- This review identified 6 articles that met the inclusion criteria
- Results from the included studies were inconsistent.
- Many critical limitations in study design and conduct were identified in the included studies.
- The 2020 Committee could not draw conclusions.
How up-to-date is this systematic review?
- This review searched for studies from January, 2000 to September, 2019.
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Technical Abstract
Background
- This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.
- The 2020 Dietary Guidelines Advisory Committee, Frequency of Eating Subcommittee conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.
- The goal of this systematic review was to examine the following question: What is the relationship between the frequency of eating and growth, size, body composition, and risk of overweight and obesity?
Conclusion statement and grade
- Insufficient evidence is available to determine the relationship between the frequency of eating and growth, size, body composition, and risk of overweight and obesity. (Grade: Grade not assignable)
Methods
- A literature search was conducted using 4 databases (PubMed, Cochrane, Embase, and CINAHL) to identify articles that evaluated an intervention or exposure of the frequency of eating and the outcome of growth, size, body composition, and risk of overweight and obesity. A manual search was also conducted to identify articles that may not have been included in the electronic databases searched. Articles were screened by two authors independently for inclusion based on pre-determined criteria.
- Data extraction and risk of bias assessment were conducted for each included study, and both were checked for accuracy. The Committee qualitatively synthesized the body of evidence to inform development of a conclusion statement(s), and graded the strength of evidence using pre-established criteria for risk of bias, consistency, directness, precision, and generalizability.
Summary of the evidence
- This systematic review was undertaken to examine the relationship between the frequency of eating and growth, size, body composition, and risk of overweight and obesity.
- Frequency of eating was defined as the number of daily eating occasions.
- An eating occasion was defined as an ingestive event (solid food or beverage, including water) that was either energy yielding or non-energy yielding.
- This review included 6 studies published between January 2000 and September 2019 that met the inclusion criteria for this systematic review: 1 randomized controlled trial and 5 prospective cohort studies.
- Four out of 6 included studies reported an association between frequency of eating and at least one growth, size, body composition, or overweight and obesity outcome. However, the studies were inconsistent in terms of how they defined and examined frequency of eating, the outcomes they examined, and their reported results.
- Several critical limitations were identified within the body of evidence:
- Studies varied in intervention or exposure assessment methods.
- Definitions of eating occasions and number of eating occasions in the comparison groups varied in every included study.
- Outcomes varied across studies: BMI, change in BMI, body fat, fat-free mass, waist circumference, change in waist circumference, 5 kg weight gain, weight change, subcutaneous fat, preperitoneal fat, and abdominal fat index.
- Eating frequency assessment was only conducted at baseline leading to concerns of possible changes over time.
- Both energy yielding and non-energy yielding beverages were inconsistently accounted for within eating occasion definitions across studies.
- Water consumption was not explicitly mentioned in any included studies.
- High or unknown attrition rates.
- Study populations did not fully represent the race/ethnic or socioeconomic diversity of the American population.
- Due to the inconsistency and limitations in the body of evidence included in this systematic review, it was determined that the evidence was insufficient to draw conclusions about the relationship between frequency of eating and growth, size, body composition, and risk of overweight and obesity.
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Full Systematic Review
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Suggested citation: Heymsfield S, Boushey C, Leidy H, Mattes R, Kleinman R, Callahan E, Butera G, Terry N, Obbagy J. Frequency of Eating and Growth, Size, Body Composition, and Risk of Overweight and Obesity: A Systematic Review. July 2020. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/10.52570/NESR.DGAC2020.SR0601.
Where do I find more information about this project? |